- Humana (Indianapolis, IN)
- …and/or Medicare . + 2+ years of management or supervisory experience. + Active Registered Nurse ( RN ) license, licensed Clinical Social Worker (LCSW) or ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Humana (Nashville, TN)
- …sciences, or health-related field. + Care Management certification (CCM). + Active, unrestricted, Registered Nurse ( RN ) license or Licensed Mental Health ... Virginia. + Three (3) or more years of managed care experience in Medicare and/or Medicaid , specifically in the delivery of care for elderly or special needs… more
- Commonwealth Care Alliance (Boston, MA)
- …This includes: Corrective Action Plan (CAP) management, regulatory reporting to Centers for Medicare & Medicaid Services (CMS), State Agencies and Department of ... direct work experience in regulatory affairs and/or compliance in Medicare or Medicaid required + 5 or...applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance is an… more
- Humana (Columbus, OH)
- …guidelines/procedures **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) with compact license with no ... and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the...to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel,… more
- The Cigna Group (Bloomfield, CT)
- …to culturally diverse situations, clients and customers. **Minimum requirements:** + Active unrestricted Registered Nurse ( RN ) license in state or territory ... + Ideal candidate would have previous case management experience with the Medicare / Medicaid population specifically focusing on Special Needs Plan. Model of… more
- ABCM Corp (Mount Vernon, IA)
- Medicare Coordinator - RN /LPN - Day Shift,...to the English language + Per the Centers for Medicare and Medicaid Services (CMS), COVID-19 vaccination is ... / Requirements + Must have an unrestricted and active Iowa (or compact state) RN /LPN license + Must possess and maintain knowledge of current state and federal… more
- ABCM Corp (Nevada, IA)
- Medicare Coordinator - RN /LPN - Full-Time...to the English language + Per the Centers for Medicare and Medicaid Services (CMS), COVID-19 vaccination ... / Requirements + Must have an unrestricted and active Iowa (or compact state) RN /LPN license + Must possess and maintain knowledge of current state and federal… more
- ABCM Corp (Aplington, IA)
- Medicare Coordinator - RN - Full-Time ABCM...to the English language + Per the Centers for Medicare and Medicaid Services (CMS), COVID-19 vaccination is ... / Requirements + Must have an unrestricted and active Iowa (or compact state) RN license + Must possess and maintain knowledge of current state and federal… more
- Commonwealth Care Alliance (Boston, MA)
- …(5) years of clinical experience in medical or behavioral health care delivery + Medicare and Medicaid managed care experience + Must have experience overseeing ... degree in business health related field preferred. + Active RN license in MA required. + 8‐10 years of...performance standards. + Experience with managing clinical services for Medicaid / Medicare patients + Demonstrated knowledge of NCQA,… more
- The Cigna Group (Bloomfield, CT)
- …team. + Other duties as assigned. **Qualifications** : + Active and Unencumbered Compact Registered Nurse licensure required + A minimum of three or more years ... experience in acute care, home health or case management experience. + Medicare and/or Medicaid experience with geriatric populations a plus + Certified Case… more
- Molina Healthcare (Glen Allen, VA)
- **JOB DESCRIPTION** For this position we are seeking a ( RN ) Registered Nurse or LMHP who lives in VIRGINIA and must be licensed for the state of VIRGINIA. ... identifying opportunities for improvement. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational… more
- Molina Healthcare (Detroit, MI)
- **JOB DESCRIPTION** This position will support our MMP ( Medicaid Medicare Population) that is part of the Community Well Services team. This position will have a ... + Required License, Certification, Association + Active, unrestricted State Registered Nursing license ( RN ) in good standing + If field work is required,… more
- The Buckingham (Houston, TX)
- …functions. Responsibilities: + Maintains current knowledge base of guidelines for Medicare / Medicaid providers. + May conduct pre-admission assessments for ... + Analyze all MDS assessments prior to final submission to Center for Medicare / Medicaid Services (CMS) using the standard organizational software (CareWatch) +… more
- Signature Healthcare (Memphis, TN)
- …processes. What you Need to make a Difference + Current licensure as a Registered Nurse with ability to obtain multi-state licensures. + Minimum of five ... 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have...(5) years related experience as a licensed Registered Nurse in a long-term care setting.… more
- Bon Secours Mercy Health (Greenville, SC)
- …and update documentation at least every two to three (2-3) business days. **All Medicare , Medicaid and indigent Observation patients are reviewed daily and sent ... and operational excellence. **Primary Function/General Purpose of Position** The RN Care Manager is a key contributor to the...that do not meet the approved criteria. Refer all Medicare , Medicaid and Self-pay patients to Physician… more
- Lancaster General Health (Lancaster, PA)
- …NCLEX within 60 days of starting in their RN role. + A graduate registered nurse may only practice professional nursing under supervision and if the graduate ... registered nurse holds a current temporary practice... nurse is practicing. + All Clinical Nurse 1 RN 's will be required to...+ A health care provider in good standing with Medicare , Medicaid , and other federal and state… more
- Lancaster General Health (Lancaster, PA)
- …NCLEX within 60 days of starting in their RN role. + A graduate registered nurse may only practice professional nursing under supervision and if the graduate ... area or unit where the graduate registered nurse is practicing. + For Magnet designated RN...+ A health care provider in good standing with Medicare , Medicaid , and other federal and state… more
- Lancaster General Health (Lancaster, PA)
- …NCLEX within 60 days of starting in their RN role. + A graduate registered nurse may only practice professional nursing under supervision and if the graduate ... area or unit where the graduate registered nurse is practicing. + For Magnet designated RN...+ A health care provider in good standing with Medicare , Medicaid , and other federal and state… more
- Lancaster General Health (Lancaster, PA)
- …care coordination. **JOB REQUIREMENTS** **MINIMUM REQUIRED QUALIFICATIONS:** + Current licensure as a Registered Nurse , issued by the PA State Board of Nursing + ... phlebotomy experience + A health care provider in good standing with Medicare , Medicaid , and other federal and state health insurance programs, ie not excluded… more
- New York State Civil Service (Binghamton, NY)
- NY HELP No Agency Mental Health, Office of Title Registered Nurse Supervisor 1 Psychiatric, Greater Binghamton Health Center, Children and Youth, P24978 ... of New York State: have permanent status as a Registered Nurse Supervisor 1 Psychiatric (formerly ...or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded… more