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Review aging accounts receivable with Project Controls Specialist and Operation Manager to determine who will follow up with clients for payment status. Meet with Project Controls Specialist and Operation Manager to review, discuss, and resolve issues with invoicing and documentation provided.
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Embark on a transformative journey with Endeavor HCBS LLC. at our Phoenix Office, where your unwavering passion for the special needs community and extensive experience in roles like HCBS Coordinator, Care Manager, Group Home Manager, or Direct Support Professional can take center stage.
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Join the Prestige Care Family in the Resident Care Manager (RN) – MDS Nurse role. does the Resident Care Manager (RN) – MDS Nurse do? Acute Care Conditions (MACC), Nutrition at Risk (NAR), Utilization Review (UR.
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Lead Tenet Utilization Review Teams market structure and operations management to effectively support utilization review and authorization confirmation functions to promote an appropriate level of care and prevent payer denials.
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Conducts admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is warranted based on established criteria and critical thinking.
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Coordinates with the Clinical Coordinator/Clinical Nurse Manager/Assistant Nurse Manager/Nursing Shift Manager to ensure supplies are appropriately utilized and inventory is sufficient for patient care.
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The RN Utilization Review II is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services.
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Every three years, serve as HMSA's internal lead for NCQA's re-accreditation review by gathering all necessary documents and information from business areas, managing timely document submissions to NCQA, facilitating NCQA requests for additional information, and coordinating onsite review activities.
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Participate in leadership team by activelycontributing in decision making, grievance follow up, building and company-wideinitiatives and attending leadership team meetings such as stand up, ManagingAcute Care Conditions (MACC), Nutrition at Risk (NAR), Utilization Review (UR),Quality Assurance Performance Improvement (QAPI) and other meetings asrequired.
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Qualifications The Foster Care Case Manager has a master’s degree in social work, sociology, psychology, counseling, or related human services field and two years’ experience working with children and families.
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License(s) or Certification(s) in Certified Internal Auditor (“CIA”), Certified Public Accountant (“CPA”), or Certified Regulatory Compliance Manager (“CRCM”) desired, but not required. Experience in first-line underwriting and second-line credit risk management/ adjudication or loan review is required.
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The Commercial Credit Review Senior Manager is responsible for executing an independent, risk-based assurance review of assigned platforms within Capital One Bank’s commercial credit portfolio, including assessment of credit practices, effectiveness of policy implementation and risk rating accuracy.
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This investigation includes but is not limited to a criminal, civil litigations and regulatory review, employment, education, and credit review (role dependent). The Senior Manager, Fiduciary Tax supports that purpose by helping to ensure that FPTC is meeting its fiduciary duties to beneficiaries and clients.
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Reviews monthly dashboards, readmission reports, quarterly, and other reports with the assigned Clinical Team Manager, as needed, to assist with the identification of opportunities for improvement.
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Oversee and champion the Metal Finishing Risk Management and Contract Review Processes. Review of Engineering Process / Quality functions. This position will interface with all levels of the organization regarding customer requirements lead a team to support NADAP accreditation for Dynomax's Metal Finishing operations.
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review care manager jobs Title: manager clinical Company: Upmc Pittsburgh Medical Center
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