- Care Advantage Inc. - Skilled Care Division (Richmond, VA)
- …Chesterfield, Chesterfield area as well as some of the surrounding areas. Care Advantage Skilled is our Medicare -certified home health company offering a wide ... Care Advantage Skilled is looking to add a Medical...under the direct supervision and direction of the Clinical Manager . The Social Worker provides psychosocial assessments/status, diagnosis and… more
- The University of Miami (Miami, FL)
- …sheet. 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 Care...on a team for data collection, health outcomes reporting, Medicare Advantage HEDIS clinical audits, and programmatic… 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)
- …specific to program/client requirements. Skills + Insurance verification, Prior authorization, Case management, benefit investigation, medicare part d, benefit ... delivery, pharmaceutical insurance Top Skills Details + Insurance verification,Prior authorization, Case management,benefit investigation, medicare part d,benefit delivery,pharmaceutical insurance… 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
- Rush University Medical Center (Chicago, IL)
- …third party payers including but not limited to Managed Care Commercial payers, Medicare Advantage payers and Medicaid payers and negotiating managed care ... Offers may vary depending on the circumstances of each case . **Summary:** Rush Health is a clinically integrated network...highly desirable. + Experience with governmental programs related to Medicare , Medicaid and Medicare Advantage … 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
- Molina Healthcare (Rochester, NY)
- …behavioral health settings. Preferred License, Certification, Association Active, unrestricted Certified Case Manager (CCM) To all current Molina employees: If ... Medicare /Dual Special Needs Populations DSNP, and Medicaid Advantage Plus -FIDE /HIDE DSNP are highly preferred. Prior...per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in member's… 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
