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Description The Risk Adjustment Representative 2 conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other ..
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Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
Description Do you thrive on working on the cutting edge? Working with innovators in the early stages of ideas, products, or platforms? Do you want to transform an industry? Crave new ..
Details Department: Health Information Management Schedule: PRN Hospital: Ascension St. Agnes Location: Baltimore, MD Bachelors in Nursing, with at least 1 year of either CDI , Quality, or Care Management experience ..
Description Job Description Summary The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..
Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..
Description The Associate Director, Clinical Pharmacy monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM knowledge to develop, ..
Description Job Summary: The Medical Insurance Specialist teams perform several types of ... coordinates information between the patients, insurance companies and our clients. Job ... claims. Responsibilities: Follow up with..
Description iCare is seeking an Enrollment Specialist who will support the iCare enrollment processing duties for all lines of business including Medicare, Medicaid, Family Care Partnership (FCP) and BadgerCare Plus. Responsibilities ..
Description Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain ..
Description Job Description Summary Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to ..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
Location: Silver Spring, MD Department: ABA Services Posted: 05/25/2023 Location Name: Maryland Wage: TBD Come join a team of passionate therapists providing excellent pediatric therapy to children throughout the United States! ..
Location: Temple Hills, MD Department: ABA Services Posted: 05/25/2023 Location Name: Maryland Wage: TBD Shift: 9:00am-5:30pm Monday Through Friday Some Weekends Come join a team of passionate therapists providing excellent pediatric ..
Description The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder ..
Float Patient Service Specialist - Towson, MD Job ID ... If so, the Patient Service Specialist role could be a great ... Working as a Patient Service Specialist at Select..
Job Location Rockville, MD - 1100 - Rockville, MD Position Type Full Time Salary Range $36,000.00 - $39,000.00 Salary/year There's a spot on our team waiting for you! Become a Team ..
... is looking for an experienced Healthcare Investigator to join its industry ... areas Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 1 year of..
Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..
What You Will Do: Emergency Department Registration Specialist Part Time - Night 11p-7:30a Varied days to include e/o weekend UM Baltimore Washington Medical Center Glen Burnie, Maryland The Power of Caring ..
