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Minimum Qualifications:Bachelor’s Degree in Social Work or PsychologyOne year of experience in hospital social work or protective servicesWorking knowledge/experience in utilization management, managed care, and payor issuesEssential Job Functions:Assesses patients and family’s psychosocial risk factors through evaluation of prior functioning levels, appropriateness and adequacy of support systems, reaction to illness and ability to cope.
Full-timeExpandApply NowActive JobUpdated 16 days ago - UpvoteDownvoteShare Job
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Monitors and tracks the total hospital certified days of the patient for payers (commercial, managed care, and Medicaid) and communicates missing certifications to the DCM, Case Manager(s), and CBO. Initiates and completes insurance pre-certification for patients lacking certification.
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Working knowledge of Medicare, managed care, inpatient, outpatient and home health continuum, as well as utilization management , discharge planning and case management.
$93,000 - $125,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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MetaSense, Inc. is seeking a travel nurse RN Case Management for a travel nursing job in Detroit, Michigan. Certification in Case Management (CCM) by the Commission for Case Management Certification (CCMC) preferred.
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Three or more years in Managed Care with experience in service coordination, medical and behavioral health utilization management, medical record review, discharge planning, data analysis, and case management of acute and chronic illness.
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An experienced Current New York State Licensed Social Work or RN with a Managed Care Plan background, experience in MLTC and/or Medicare Advantage Plans, with an emphasis on Care/Case Management, strong understanding of UAS-NY assessments and manager-level experience.
Full-timeExpandApply NowActive JobUpdated 28 days ago - UpvoteDownvoteShare Job
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Experience and proven success in hospital management skills, with progressive expertise in case management, utilization review, discharge planning, home care and/or managed care.
$190,600 - $230,000 a yearExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Tracks Skilled (MRA/MCO/MCG/MMP) customers utilizing Case Management Tools to determine continued and appropriate Medicare/Managed Care eligibility and benefit period through regular communications with Regional Care Management Specialist, Business Office and external Case Managers.
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Minimum 2 years "telephonic" Case Management experience with a Managed Care Company preferred. The "Telephonic" Nurse Case Manager II is responsible for performing care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum.
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Evaluation of Members:- Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member’s needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal and external programs/services.
$31.25 - $65,000Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Knowledge of care transitions, utilization management, case management, performance improvement and managed care reimbursement. Work Experience: Case Management experience in a acute care hospital.
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Experience includes case management/discharge planning in one of the following settings: Acute care, Home care, LTC care, Physician Office or Managed Care company.
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Experience with utilization management, knowledge of MCG / criteria, managed care language, and CMS rules and regulations preferred. NATURE OF SUPERVISION: -Responsible to: Manager of Case Management ENVIRONMENT: Blood borne Pathogens: A Office setting.
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CASE MANAGEMENT experience required JOB REQUIREMENTS: Registered Nurse (RN) with current, valid, unrestricted license in state of operations 2 years clinical practice experience of direct clinical care to the customer 1 year experience in Condition Management or Case Management in a health insurance, managed care, physician office or hospital setting.
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Must have working knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement. The CM is responsible for identifying, initiating, and managing optimal patient flow/throughput to enhance continuity of care, smooth and safe transitions, patient satisfaction, patient safety, and length of stay management.
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care management managed case jobs Title: management in Rogers, Arkansas
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