- Fallon Health (Worcester, MA)
- …for member experience and service and clinical quality. **Brief Summary of Purpose:** The Behavioral Health Case Manager (BHCM) is responsible for assessing ... with a special focus on those who qualify for Medicare and Medicaid. We also serve as a provider...member's primary care physician, medical providers, behavioral health providers, state agencies and/or internal nurse case… more
- Elevance Health (Smithfield, RI)
- …Medicare Medical Director** is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... **Medical Director- Medicare (Part-time)** Location: This role enables associates to...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
- Fallon Health (Milford, MA)
- …approves their care plan o Manages NaviCare members in conjunction with the Navigator, Behavioral Health Case Manager, Aging Service Access Point Geriatric ... we strive to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE...or her health needs, social needs or behavioral health needs o Collaborates with appropriate… more
- Highmark Health (Providence, RI)
- **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding ... in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Determine...works with external resources to create and monitor inpatient case mix reports and the top 25 assigned DRGs/APCs… more