- Humana (Providence, RI)
- …scenarios arise from outpatient , inpatient or post-acute care environments. The Medical Director will have discussions with external physicians by phone to ... caring community and help us put health first** The Medical Director relies on medical ...work is assisted by diverse resources, which may include national clinical guidelines, state policies, CMS policies and determinations,… more
- CenterWell (Providence, RI)
- …processes, and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, ... caring community and help us put health first** The Medical Director , Primary Care relies on ...work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference… more
- Humana (Providence, RI)
- …processes, and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, ... caring community and help us put health first** The Medical Director relies on medical ...work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference… more
- Humana (Providence, RI)
- …processes, and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, ... caring community and help us put health first** The Medical Director actively uses their medical...work is assisted by diverse resources, which may include national clinical guidelines, CMS and state policies and determinations,… more
- Genesis Healthcare (Brockton, MA)
- Overview **FULL-TIME DIRECTOR OF REHAB** At Powerback, we're on a mission to improve lives. As the leader in physical, occupational, speech, and respiratory ... reach spans skilled nursing centers, assisted and independent living facilities, outpatient clinics, and home-based care. We're proud to deliver personalized care… more
- Riverside Community Care (Milford, MA)
- …of dedicated behavioral health/substance use/co-occurring professionals in a unique outpatient setting. The Co-Occurring Clinical Team Manager (CTM) oversees all ... quality care. Responsibilities include but are not limited to: + Partnering with director level management to align team with CBHC values and mission + Leading… more
- Cardinal Health (Providence, RI)
- …of documentation and coding related to physician or hospital (inpatient and outpatient ) billing and/or medical necessity reviews. + Prepares written reports ... and compliance issues. **Compliance Audit Manager** Reporting to the Compliance Director , this position supervises and manages compliance audits to determine… more
- Cognizant (Providence, RI)
- …. Draft and submit the medical necessity determinations to the Health Plan/ Medical Director based on the review of clinical documentation in accordance with ... the Health Plan/Payer. The comprehensive process includes analyzing, reviewing, and processing medical necessity denials for resolution. You will be a valued member… more
- Datavant (Providence, RI)
- …and existing coders. **You Will:** + Conduct inpatient coding audits on medical records, utilizing ICD-10-CM, CPT, and appropriate coding references for accurate DRG ... results for review by the facility or CCS HIM director . + Review disagreements on APC/DRG changes with the...trauma centers + Experience coding and auditing inpatient and outpatient records for various facilities + Track record of… more
- State of Massachusetts (Taunton, MA)
- …forensic consultations as requested by the Recovery from Addictions Program (RAP) Facility Medical Director . This may involve meeting with clients and their ... documentation of individualized care and treatment plans. * Ability to recognize medical conditions and refer for appropriate care. * Skilled in conducting… more
- Genesis Healthcare (Cumberland, RI)
- …reach spans skilled nursing centers, assisted and independent living facilities, outpatient clinics, and home-based care. We're proud to deliver personalized care ... Powerback is the place for you. **Why Powerback?** + **Benefits** : We offer Medical , Dental, and Vision plans to Full-Time team members. We offer Dental and Vision… more
- Genesis Healthcare (Cumberland, RI)
- …reach spans skilled nursing centers, assisted and independent living facilities, outpatient clinics, and home-based care. We're proud to deliver personalized care ... Powerback is the place for you. **Why Powerback?** + **Benefits:** We offer Medical , Dental, and Vision plans to Full-Time team members. We offer Dental and… more