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We CARE for our patients like they are our own FAMILY. Note: The Centers for Medicare & Medicaid Services (CMS), in collaboration with the Centers for Disease Control and Prevention (CDC), require COVID-19 vaccinations for all Medicare and Medicaid certified providers.
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Alternate Solutions Health Network LLC is seeking a Registered Nurse (RN) Home Health Hospice for a nursing job in Akron, Ohio. Job Description & Requirements Specialty: Hospice Discipline: RN Start Date: ASAP Duration: Ongoing Employment Type: Staff Agency: Summa Health at Home and Hospice Our culture and people are what set us apart from other post-acute care providers.
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Knowledgeable of InterQual and Milliman Care Guidelines (MCG) medical necessity criteria Understanding of Medicare, Medicaid and third party reimbursement methodologies. The Clinical Appeals Nurse will review each case identified/referred for appeal based on Milliman Care Guidelines (MCG), InterQual, and/or other relevant guidelines, determined the viability of the appeal, and manage the appeal process.
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1+ years of experience in medical records coding (HCC Coding) with knowledge of Medicare, Marketplace, and Medicaid risk adjustment is required. 2+ years of experience in coding with knowledge of Medicare risk adjustment (HCC Coding.
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At FutureCare our RNAC-Registered Nurse Assessment Coordinator/MDS are part of our interdisciplinary team of nurses who play a vital role in adequately collecting and assessing data on our residents to ensure specific elements are encoded in the MDS and submitted to the Centers for Medicare and Medicaid Services.
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Monday-Friday 8:15-5:00 On call per business need Holiday on call rotation Territory: West Chester, Sharonville, Blue Ash, Lebanon, Mason, Monroe, Morrow, Willmington, Midland, Milford, Lynchburg areas HOW YOU'LL MAKE A DIFFERENCE: As a Registered Nurse Case Manager (RNCM) you will make a difference in the lives of our patients.
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Instruct patient and family members on proper use of equipment such as wheelchairs, braces, walkers, crutches, canes, and other prosthetic/orthotic devices Policies: Completes all clinical documentation following agency protocol and Medicare/Federal guidelines.
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Strong understanding of government payers including Medicare Part D, Medicare Part B, Medicare Advantage, and Medicaid. The Policy practice focuses on a broad range of issues including: Medicare Part D and the IRA, risk adjustment and payment modeling for Medicare Part D and Medicare Advantage, the 340B Drug Pricing Program, drug pricing reform, alternative payment models (e.g., CMS Enhanced Oncology Model, Accountable Care Organizations), PBM reform, vaccines, and state/federal policy developments.
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This position is responsible for the intake process of all Medicaid requests for services in accordance with Medicare and NYS Medicaid Guidelines as well as departmental criteria and guidelines.
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Under the supervision of the Vice President of Operations (VPO), and the Vice President of Clinical Reimbursement, the Regional Reimbursement Manager is responsible for training and management of the Clinical Case Manager in a manner that supports SLP Operations, LLC’s philosophy, and policies, maintaining RAI/MDS compliance with federal and state regulations, Medicare reimbursement and state-specific regulations for Medicaid Case Mix.
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If employed at one of our senior living communities that receives Medicare or Medicaid funding, team members must not be considered an “Excluded Party” as defined by the U.S. Department of Health and Human Services, any state Medicaid Programs, and any additional federal and state government contract programs.
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Registered Nurse (RN) with current New York State license. Completes and signs progress notes, nursing assessments, incident reports, and other required documentation in accordance to the New York State Office of Mental Health (OMH) regulations, the New York City Department of Health and Mental Hygiene (DOHMH) guidelines, and Medicaid billing standards and regulations.
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Required 2+ years of experience in coding with knowledge of Medicare risk adjustment (HCC Coding) CPC, CPC-H, CPC-P, CRC, CCS, CCS-P, RHIT, RHIA or CPMA. CRC is required within the first year of employment.
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Job Summary: We are seeking a dedicated Certified Registered Nurse Anesthetist (CRNA) who is committed to providing exceptional anesthesia care and accepts Medicare. Current certification as a Nurse Anesthetist (CRNA) and licensure as a registered nurse (RN.
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They must competently and accurately utilize approved screening criteria (InterQual/MCG/Centers for Medicare and Medicaid Services "CMS" Inpatient List). The RN Utilization Review Nurse collaborates as necessary with other members of the health care team to ensure the above according to the mission of CHRISTUS.CHRISTUS Santa Rosa Hospital - Westover Hills (CSRH-WH) is a 150-bed hospital serving the fastest growing area of San Antonio.
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medicare medicaid registered nurse jobs Title: coordinator Company: Ascension Health
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