- Amergis (Albuquerque, NM)
- 6 month TEMP to PERM $25/hr - MUST HAVE A BACHELORS Modality: Non - Clinical Case Manager Openings:2 Shifts:Days, 1 wknd shift/wk Hours per Week:40 Contract ... role will be supporting the youth with coordinating community resources The Non - Clinical Case Manager coordinates referrals, serviceplanning, and client… more
- Healthfirst (NM)
- The Case Manager , Utilization Management coordinates the care plan for assigned members and conducts pre-certification, concurrent review, discharge planning, ... and case management as assigned. The Case Manager , Utilization Management is also responsible...medical necessity of treatments and service utilizations based on clinical documentation, regulatory, and InterQual/MCG criteria + Assessment -… more
- Molina Healthcare (Albuquerque, NM)
- … Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse (RN) provides support for internal...of care. * Applies appropriate criteria on PAR and Non -PAR (contracted and non -contracted) cases and with… more
- Sharecare (Santa Fe, NM)
- …years' experience in Care/ Case Management + NCQA experience preferred + Certified Case Manager preferred + Prior management and supervision of a clinical ... for everyone. To learn more, visit www.Sharecare.com. **Job Summary:** The VBCM Operations Manager will report to the Director of Clinical Care Operations,… more
- Sharecare (Santa Fe, NM)
- …+ Training in motivational interviewing preferred. + Minimum 3-5 years varied clinical experience with telephonic Case Management experience strongly preferred. ... and affordable for everyone. To learn more, visit www.Sharecare.com. The Care Manager supports the implementation of the Value Based Care Management program in… more
- Veterans Affairs, Veterans Health Administration (Albuquerque, NM)
- …System (NMVAHCS), Ambulatory Care Service, is seeking a qualified full-time Nurse Manager (Ambulatory Care - Women's Health) to join our team! Responsibilities The ... Nurse Manager (NM) is the designated first-line supervisory authority and...care. Ensures compliance with accreditation and regulatory standards. Aligns nursing/ clinical objectives with organizational strategic outcomes, participating in strategy… more
- Datavant (Santa Fe, NM)
- …and appropriate coding references for accurate DRG and APC assignment. + Review non -CC/MCC records to assess proper coding or identify the need for additional ... CCS HIM director. + Review disagreements on APC/DRG changes with the appropriate manager . + Prepare the final reports for the coding audit and actively participates… more
- Sharecare (Santa Fe, NM)
- …+ Referring members to Clinical Advocates (Nurse) for conditions that require clinical care and case management assistance + Primary duties include but are ... during the training period will be evaluated on a case by case basis and must be...Physical Therapy Assistant + Nursing Assistant + Medical Secretary/Clinic Manager + Radiology Technician + Home Health Aide +… more
- Molina Healthcare (NM)
- …Association** Active, unrestricted Transitions of Care Sub-Specialty Certification and/or Certified Case Manager (CCM) To all current Molina employees: If ... ICT collaboration. + RNs provide consultation, recommendations, and education as appropriate to non -RN case managers. + RNs are assigned cases with members who… more
- Molina Healthcare (Albuquerque, NM)
- …Preferred Qualifications * Transitions of care sub-specialty certification and/or Certified Case Manager (CCM). * Hospital discharge planning or home ... services, and advance directives. * Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.… more