- Highmark Health (Dover, DE)
- …+ 3 years of experience in working in Acute Care/Managed Care/Medicaid and Medicare populations. + Case Management Certification + Proficiency in Electronic ... with external contacts. + Communicate effectively while interacting with Case Management Specialists, Management Team, Physician Advisors and other interdepartmental… more
- US Tech Solutions (May, OK)
- …best-in-class service experience.. **Responsibilities:** + The role involves ensuring the accuracy of case setup and clinical review of Medicare appeals cases by ... for case decisions. + It requires adherence to work instructions and Medicare guidelines to ensure proper case processing. The position also demands… more
- CVS Health (Bensalem, PA)
- …preference: (diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac) with Medicare members. - 2 years Case Management, discharge planning, and/or ... comprised of network management, clinical coverage, and policies. Community Care Case Manager's use a collaborative process of assessment, planning, facilitation,… more
- CVS Health (Harrisburg, PA)
- …preference: (diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac) with Medicare members. - 2 years Case Management, discharge planning, and/or ... all with heart, each and every day. **Position Summary** Community Care Case Manager use a collaborative process of assessment, planning, facilitation, care… more
- CVS Health (Tallahassee, FL)
- …Kidney Disease (CKD), post-acute care, hospice, palliative care, cardiac, home health with Medicare members + 2+ years case management, discharge planning and/or ... and healthcare personnel as appropriate. + Implements and coordinates all case management activities relating to catastrophic cases and chronically ill… more
- BAYADA Home Health Care (Orlando, FL)
- …for quality and adherence to policies and procedures. As a member of the Medicare Case Management (MCM) office, individuals in this role are expected to ... Manager provides support to all BAYADA Home Health Care Medicare service offices by monitoring Outcome and Assessment Information...the OASIS and ICD 10 coding while using the Medicare PDGM billing model and CMS guidelines. + Review… more
- Genesis Healthcare (Clayton, NM)
- …MDS Nurse -- RN manages the overall process and tracking of all Medicare /Medicaid case -mix documents to ensure appropriate reimbursement for all services ... Medicare /Medicaid reimbursement, MDS completion, clinical resource utilization and/or case management is highly desirable. *Must maintain current BLS/CPR… more
- Highmark Health (Dover, DE)
- …management or leadership role **Preferred** + 1 year in a home clinical or case management role + Medicare or Medicaid experience **LICENSES or CERTIFICATIONS** ... :** **JOB SUMMARY** This job supervises a team of Case Manager Supervisors who are charged with promoting quality...with excellent team building and professional development skills + Medicare and Medicaid experience + Managed care experience +… more
- Henry Ford Health System (West Bloomfield, MI)
- …of preventive service guidelines, clinical practice guidelines, behavior change theory, Medicare and Medicaid regulations and case management principles. ... (24 HOUR), MIDNIGHTS 7:00PM TO 7:30AM GENERAL SUMMARY: The Case Manager is a member of the hospital or...and family's health care needs. The goals of the case manager are to promote patient safety, quality of… more
- Henry Ford Health System (Detroit, MI)
- …of preventive service guidelines, clinical practice guidelines, behavior change theory, Medicare and Medicaid regulations and case management principles. + ... The Case Manager Social Worker provides therapeutic intervention and...and departmental policies and procedures. GENERAL SUMMARY: + The Case Manager is a member of the hospital or… more