- Optum (Boulder, CO)
- …on a global scale. Join us to start Caring. Connecting. Growing together. The Case Manager RN is responsible and accountable for coordination of patient services ... medical unit to drive timely discharges and plans of care CMS Compliance: All Medicare and Medicare Advantage patients are required a delivery notice… more
- Henry Ford Health System (Wyandotte, MI)
- …for the past 34 consecutive years. PART TIME 20 HOUR DAYS GENERAL SUMMARY: The Case Manager is a member of the hospital or specialty-based patient-centered care ... and family's health care needs. The goals of the case manager are to promote patient safety,...preventive service guidelines, clinical practice guidelines, behavior change theory, Medicare and Medicaid regulations and case management… more
- FC Compassus LLC (Youngstown, OH)
- …Mercy Health by Compassus Position Summary The Inpatient Unit (IPU) Registered Nurse Case Manager is responsible for modeling the Compassus values of Compassion, ... company, among all departments, and all external stakeholders. The IPU Registered Nurse Case Manager functions as a member of the Interdisciplinary Team (IDT)… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …throughout the five (5) boroughs. Territory Management + Maintain CPHL MAP and Medicare Advantage Plan visibility in the community by monitoring multiple ... performing all required tasks assigned by the Sales Field Manager . Incumbent will be responsible for educating and enrolling...issued by Centers Plans for Healthy Living MAP and Advantage Care Medicare HMO Plan. Enrollment application… more
- Medical Mutual of Ohio (OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. Under limited ... within 60 days of date of hire. + Certified Case Manager (CCM) or other industry recognized...self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… more
- TEKsystems (Morrisville, NC)
- …on specific program/client requirements. Skills: Insurance verification, Prior authorization, Case management, benefit investigation, medicare part d, benefit ... Training: 6 to 8 weeks, onsite. Responsibilities: + Reimbursement Case Managers will serve as an expert on reimbursement,...by all payer types, including private/commercial and government (ie, Medicare , Medicaid, VA, and DOD); with expertise in … more
- TEKsystems (Morrisville, NC)
- Now Hiring: Reimbursement Case Manager | Entry-Level | Remote (On-site Training in Morrisville, NC) Are you ready to launch your career in healthcare support and ... patient advocacy? We're looking for a Reimbursement Case Manager who's passionate about helping patients...Insurance verification & benefit investigation + Prior authorization & case management + Medicare Part D knowledge… more
- Henry Ford Health System (Wyandotte, MI)
- …for the past 34 consecutive years. PART TIME 20 HOUR DAYS GENERAL SUMMARY: The Case Manager is a member of the hospital or specialty-based patient-centered care ... and family's health care needs. The goals of the case manager are to promote patient safety,...preventive service guidelines, clinical practice guidelines, behavior change theory, Medicare and Medicaid regulations and case management… more
- TEKsystems (Morrisville, NC)
- Reimbursement Case Manager Location: Morrisville, North Carolina (Hybrid work setup) | Full-Time Are you passionate about helping patients navigate the complex ... fast-paced, service-oriented environment? Join our team as a Reimbursement Case Manager and make a real difference...Insurance verification & benefit investigation + Prior authorization & case management + Knowledge of Medicare Part… more
- University of Miami (Medley, FL)
- …. The UHealth System at the University of Miami has an exciting opportunity for a Case Manager RN in the Population Health Department. SUMMARY The Case ... duties as directed and under the supervision of RN Manager Case Management. + Collaborates with Primary...on a team for data collection, health outcomes reporting, Medicare Advantage HEDIS clinical audits, and programmatic… more
- TEKsystems (Morrisville, NC)
- Job Posting: Reimbursement Case Manager Employment Type: Full-Time Experience Level: Entry Level Industry: Healthcare | Pharmaceutical Access & Benefits ... Skills + Insurance verification + Prior authorization handling + Case management and documentation + Medicare Part...We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are… more
- Jennie Stuart Medical Center, Inc. (Hopkinsville, KY)
- …Certification required. Required Skills: A working knowledge and understanding of Medicare / Medicare Advantage , Medicaid, Commercial, and other third-party ... and medical background to include, high-risk screenings related to case management and proposed interventions/outcomes. + Performs proactive discharge planning,… more
- Highmark Health (Pittsburgh, PA)
- …with unique processing arrangements including Federal Employee Program (FEP) and Medicare Advantage . **ESSENTIAL RESPONSIBILITIES** + Coordinates the clinical ... **Job Description :** Date Posted: 20250509 Location: Allegheny General Hospital Department: Case Management, Inpatient Status: Full Time Shift: 80 hours every two… more
- Trinity Health (Westerville, OH)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** RN Case Manager , Full-time **Why Mount Carmel?** With five hospitals ... (https://www.mcmg.mountcarmelhealth.com/) , a college of nursing (https://www.mccn.edu) , a Medicare Advantage plan (https://www.medigold.com) , and extensive… more
- Datavant (Providence, RI)
- …work environment. + Keep up to date with current coding policies for ICD-10, Medicare Advantage , HHS (ACA), and other markets. + Provide guidance and make ... vision for healthcare. As a Sr. Client Coding Project Manager , you will plan, forecast, and manage client-facing coding...+ Current CCS, CRC, or CPC required. + Previous Medicare Advantage Risk Adjustment, CDI, Medicaid, Commercial… more
- Humana (Columbus, OH)
- …put health first** Humana Healthy Horizons in Ohio is seeking a Field Care Manager to assess and evaluate member's needs and requirements to achieve and/or maintain ... appropriate for the care and wellbeing of members. Take advantage of Humana's competitive pay, lucrative 401k matching programs...future with a Fortune 500 Company! The Field Care Manager Nurse 2 (Care Manager Plus, Physical… more
- Deloitte (Tempe, AZ)
- …working knowledge of the individual medical and small group markets + Experience with Medicare products, including Medicare Advantage or Medicare ... role and compensation decisions are dependent on the facts and circumstances of each case . A reasonable estimate of the current range is $167,325 to $278,875. You… more
- Datavant (Lincoln, NE)
- …coding outcomes, measure product impact, and support value-based client delivery across Medicare Advantage , ACA, and Medicaid programs. The ideal candidate ... bold vision for healthcare. **Role Overview** As a Product Manager , Risk Adjustment Analytics Products, you will contribute to...reviewed by Datavant Human Resources and determined on a case -by- case basis. Depending on the state in… more
- Sanofi Group (Nashville, TN)
- **Job Title:** Field Reimbursement Manager , Tzield, Nashville TN **Location:** Nashville, TN (Field Based) **About the Job** Sanofi General Medicines is currently ... support of patient access + Partner with Field Sales, Case Management and Market Access teams to ensure close...provide field intelligence and disseminate payer policy and positive advantage + Serve as a primary point of contact… more
- Fresenius Medical Center (Waltham, MA)
- …enrolled in value based plans like ESRD Seamless Care Organizations (ESCOs), Medicare Advantage Special Needs Plans and other risk bearing arrangements. ... organization. + Performs other related duties as assigned. **Addendum - Manager , Clinical Deployments** This role supports the successful implementation of… more
