- Lundbeck (Edmond, OK)
- …based on customer needs and organizational goals, incorporating "total office" account management . Local Market & Therapeutic Area Expertise - Gather and validate ... anticipate and effectively address payer access issues (IDNs, Medicare, Medicaid , Commercial) using Lundbeck resources. Pharmaceutical Environment/Compliance - Ability… more
- Lundbeck (Raleigh, NC)
- …on customer needs and organizational goals, incorporating "total office" account management where applicable. Local Market & Therapeutic Area Expertise - Gather ... anticipate and effectively address payer access issues (IDNs, Medicare, Medicaid , Commercial) using Lundbeck resources. Pharmaceutical Environment/Compliance - Apply… more
- Global Channel Management Inc. (East Hartford, CT)
- About the job Medicaid Appeals Coordinator Medicaid Appeals Coordinator needs 2+ years of grievance or appeals experience Medicaid Appeals Coordinator ... Strong organizational and communication skills, oral and written. Working knowledge of Eligibility rules and processes and a willingness to gain an understanding of… more
- Savista (Hackensack, NJ)
- …living our values of Commitment, Authenticity, Respect and Excellence (CARE). The Eligibility Specialist works as an advocate for patients and maintains a level ... service centers, Client Facility or Outreach (Field work) locations the eligibility specialist helps to identify financial assistance programs for the uninsured… more
- RevOne Companies (Fort Wayne, IN)
- …the intersection of healthcare and human compassion is the role of the Patient Eligibility Coordinator - a position dedicated not just to process, but to purpose. We ... seeking a committed individual to serve as a Patient Eligibility Coordinator , working directly within one of our...enrollment in federal and state assistance programs such as Medicaid , Medicare, and ACA Marketplace plans. Each interaction you… more
- SCO Family of Services (Brooklyn, NY)
- …necessary to gain health care services, including but not limited to: 1. Medicaid 2. Cash Assistance Eligibility 3. Social Security 4. Supplemental Nutrition ... OF THE POSITION: The Care Managers service youth who are enrolled in Medicaid , have two or more chorionic conditions, HIV/AIDS, Sickle Cell, Serious Emotional… more
- City of New York (Brooklyn, NY)
- …eligibility for immediate needs grant (food and non-food); for employability and eligibility for public assistance, SNAP benefits and Medicaid ; works with ... supervising a team of BOS staff, who provide various functions of eligibility determination, financial planning, and employment planning and monitoring and other… more
- DFR (Indianapolis, IN)
- …responsible for completing and coaching TPRs for the Knowledge Services Local Office Eligibility Specialist (ES) Staff. The TPR Analyst will be accountable to the ... of DFR administered programs daily Provide consultation to Knowledge Services DFR Program Management Team to solve TPR related issues, as well as identify potential… more
- Actalent (Fort Lauderdale, FL)
- …activities as assigned. Essential Skills Clinical review Utilization review Utilization management InterQual Milliman Commercial Guidelines Medicaid Medical ... Actalent is hiring a Utilization Management Nurse! Job Description The Utilization Management...concepts, including InterQual and Milliman Criteria. Knowledge of Florida Medicaid Program and CMS Guidelines. Proficient in word processing… more
- NYC Health Hospitals (New York, NY)
- …*Working with Eligibility to create requested self-pay bills for Medicaid application *Work collaboratively with case management , UR, corp. Managed ... with the eligibility team on any missing, incomplete recertifications or Medicaid applications. *Submit bi-weekly Medicaid billing using EPIC or e-paces, and… more
- Salt River Pima-Maricopa Indian Community (Scottsdale, AZ)
- …Position Summary : Under the general supervision of the Transition Ambulatory Case Management RN Supervisor (TACMRNS), the Transition Care Management RN (TCM RN) ... in this classification. Examples of Tasks Transitional RN Case Management : Oversees the care of a patient as they...including, but not limited to, Indian Health Service, Medicare, Medicaid , ALTCS, SSI, etc. Strong verbal and written communication… more
- WMC Health (Valhalla, NY)
- …procedures for Facility Billing, Insurance Verifications, Third Party Insurance coverage, Medicaid and Medicare eligibility , Insurance denial review and overturn ... of the staff. Assists in the preparation of monthly management reports providing key revenue and operational metrics and...and bills to third party billing companies, Medicare and Medicaid , as well as insurance denial review as appropriate.… more
- Service Coordination, Inc. (Annapolis, MD)
- …Salary is determined following a review of your education, relevant case management experience and relevant certifications We reimburse for all travel and offer ... the people that we support. SCI provides quality case management and other related services by helping people understand...and monitoring services and identifying supports for people with Medicaid Home and Community Based services of varying ages… more
- UnitedHealth Group (Phoenix, AZ)
- …start Caring. Connecting. Growing together. We are currently seeking an Inpatient Care Management Medical Director to join our Optum team. This team is responsible ... care. Our clients include local and national commercial employer, Medicare, and state Medicaid plans. The Medical Directors work with groups of nurses and support… more
- Durham County (Durham, NC)
- …Incumbents are responsible for the total process of determining applicant/client eligibility and redetermination of Medicaid , Community Alternatives Program ... in a lead worker capacity. (2) performing the same eligibility determination functions as the income maintenance caseworker III....a variety of complex task and functions in the Medicaid programs which include performing two or more functions… more
- The Villages Health (The Villages, FL)
- …| Matching HSA & 401k | PTO & Paid Holidays | The Villages Charter School Eligibility | & much more! Hiring Event Please bring your resume and join us: Friday, ... billing, managers, and executives to maximize collections in the revenue cycle management process. Stays abreast of insurance terms and regulatory changes by… more
- DEVELOPMENTAL PATHWAYS (Aurora, CO)
- …(DP) has an opportunity for a Case Manager - Active in our Case Management Department. The Case Manager - Active will manage a caseload of individuals receiving ... The Case Manager - Active will complete assessments to determine eligibility for services/supports and identify individual strengths, needs, concerns, and… more
- Sentara Healthcare (Woodbridge, VA)
- …responsibilities: Performs a variety of casework duties and provides case management services to patients, families, and designated caregivers. Must develop, ... Long Term Care- 1 year; Health Plan- 1 year; Medicaid - 1 year REQUIRED At least one year of...an annual discretionary bonus if established system and employee eligibility criteria is met. Sentara Health is an equal… more
- ROCKY MOUNTAIN HUMAN SERVICES (Denver, CO)
- …the main contact for members receiving Long Term Services and Supports through Medicaid or State Funded programs. The case manager provides specialized, ongoing case ... management by monitoring services, having communication with members and...as needed. Case managers serve as the experts in eligibility assessments, service plans, and prior authorization requests (PARs).… more
- StateJobsNY (Staten Island, NY)
- …and maintain eligibility for full and unconditional participation in the Medicaid and Medicare programs. Failure to maintain Medicaid /Medicare eligibility ... individuals in identifying, developing, and practicing personalized coping and crisis management skills to deal with their psychiatric symptoms. *Interacts with… more
