- Tenethealth (Detroit, MI)
- …transition plan, e) leading and/or facilitating multi-disciplinary patient care conferences including Complex Case Review , f) making appropriate referrals to ... at hospital and department orientation is required. Department orientation includes review and instruction regarding Tenet Case Management and Compliance… more
- PharmaCord (Jeffersonville, IN)
- …contributing to the overall success of your program. When you join the team as the Case Manager, you'll have the opportunity to make a difference in the lives of our ... navigate the tricky process to getting access to their complex medication. You'll compassionately deliver an exceptional experience to...focusing on the accuracy of the details of their medical records and your mastery of the program requirements,… more
- Rebekah Childrens Service (Gilroy, CA)
- …and Employment Benefits: Competitive Salary 401K matching plan 7.5% Bilingual Stipend Excellent Medical Benefits Up to 5 weeks of combined PTO and Sick Time accrual ... group, and family therapy as well as crisis and case management to clients ages 6-21 and their families....client charts in compliance with requirements of Phase II Medical Consolidation (Title 9, Chapter 11, Section 1810.440). Demonstrates… more
- Monster (Merrifield, VA)
- …key performance indicators and establish processes and methodologies for preventative mitigation ( Complex analysis). Compile, review and prepare data to be used ... practices in broad areas of assignments and relates fields. Works on the most complex , high impact projects. Serves as a technical specialist or advisor to the IAM… more
- Health eCareers (St. Charles, MO)
- …education regarding proper documentation practices that present potential liability problems.Performs medical record review for the purpose of identification of ... and provides reports to legal counsel to assist in preparation of defense.Completes case summaries on all medical malpractice and general liability cases and… more
- Monster (Huntsville, AL)
- …correspondence including pleadings, discover, motions, orders, and notices. Schedule and maintain case calendars Research complex issues using Westlaw or Lexis ... and case law cite checks. File pleadings, motions, and other documents. Review and summarize depositions, medical records, and other documents. What you… more
- Inside Higher Ed (Denver, CO)
- …university's primary liaison with the City of Denver police, fire, emergency medical services, and emergency preparedness departments, as well as with other external ... maintains sufficient knowledge of federal, state, and local laws, case law, and regulations relating to campus safety and...chief campus safety officer will be expected to manage complex situations and staffing; role model a sincere and… more
- APTIM (Santa Fe, NM)
- **Summary:** The Senior-Level Claims Reviewer is responsible for independently reviewing, analyzing, and processing complex claims related to disaster losses in ... on claims interpretation, policy compliance, and documentation quality. The Senior Reviewer also supports mentoring of mid-level staff, provides guidance on… more
- Veterans Affairs, Veterans Health Administration (Martinsburg, WV)
- …well as customer service programs. Responsibilities The Risk Manager Clinical Reviewer (RMCR) Registered Nurse (RN) is responsible for providing competent, ... Performs clinical reviews for Occurrence Screens and/or Tort Claims and recommends Peer Review when quality of care issues are recognized. Prepares the Peer … more
- APTIM (Santa Fe, NM)
- **Summary:** The Mid-Level Claims Reviewer supports the claims process by reviewing, evaluating, and documenting claims for disaster-related losses. This role ... needed. **Key Responsibilities/Accountabilities:** + Ability to understand and interpret complex federal policy language, including relevant statutes, regulations, policies,… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …conjunction with Provider Relations, explaining processes for accessing Health Plan to perform medical review , obtains case or disease management support, or ... appropriate cases to the Medical Director for review . Refer to and work closely with Case...in improving member and community health. + Manages more complex assignments; cross-trained to review various levels… more
- The Cigna Group (Bloomfield, CT)
- …is responsible for the following: + Laboratory molecular and genetic testing clinical case review activities. + Evaluate telephone, fax, or web requests for ... coverage of services or referring requests for expert clinical review as appropriate. + Be available as an expert...Strong interpersonal skills with the ability to clearly explain complex medical information in both verbal and… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …characteristic. Blue Cross and Blue Shield of Minnesota Position Title: RN Specialist Complex Case Manager - Oncology Location: Remote Career Area: Health ... * Receives referral for member identified with high cost, complex medical conditions and telephonically outreaches to...to the member, family and providers to engage in complex case management program. * Conducts clinical… more
- Henry Ford Health System (Detroit, MI)
- …with computers, electronic health records (EHR), database systems, and utilization review / case management documentation systems. + Knowledge of CMS, commercial ... sign on bonus available for qualified experienced candidates with current 2 years RN Case Management in a large acute care hospital setting. GENERAL SUMMARY: The … more
- Henry Ford Health System (Detroit, MI)
- …of computers, Electronic Health Records, data base systems and utilization review / case management documentation systems. Desire to work collaboratively and ... for qualified experienced candidates with current 2 years MSW Case Management in a large acute care hospital setting....of services - from primary and preventative care to complex and specialty care, health insurance, a full suite… more
- Commonwealth Care Alliance (Boston, MA)
- …access clinical specialty panel physicians to assist in complex or difficult case + Ensure compliance with medical policy. Maintains compliance with all ... Director of Medical Policy and Utilization Review , the Utilization Review Medical ...issues with attending physicians and CCA clinicians + Document case review findings, actions, and outcomes in… more
- Omaha Children's Hospital (Omaha, NE)
- …Overview** The Medically Complex RN Case Manager serves the medically complex patient population at Children's Hospital & Medical Center and is a core ... effectively amongst diverse patient populations and providers. In partnership with the patient's medical health team, the RN Case Manager leads emergency care… more
- Price Benowitz LLP (Washington, DC)
- …team. Job Summary Price Benowitz, LLP is looking to add a full-time Personal Injury Medical Case Manager to join its growing team at its Washington, DC ... headquarters. You will coordinate medical case management efforts across our department,...and support to legal team members as needed. + Review and analyze clients' medical records and… more
- Guthrie (Troy, PA)
- …years of experience in an acute care setting with strong care management, utilization review , and payer knowledge. A Case Management certification or obtaining a ... Acute Case Manager Position Summary: The Acute Case...has the responsibility, accountability, and authority for coordinating the medical management of hospital patients, using outcomes-based approaches. The… more
- Select Medical (Madison, WI)
- …respiratory therapist or master's in social work and minimum three (3) years of medical case management or similar experience._** **Previous case mangement ( ... discharge planning ) experience with medically complex patients in a hospital critical care setting and...a related discipline. + Minimum three (3) years of medical case management or similar experience. +… more
