wellness, has an exciting opportunity for a Medical Case Manager 1 in our clinic in Columbia, SC... To: Manager of Case Management Services Must be able to pass a Level I background check (a Level II background may...
to fill a Medical Case Manager position in the Columbia, SC area. Work from home, and on the road. Monday – Friday, regular... business hours. As a Medical Case Manager you will make a meaningful difference in the lives of injured workers...
necessity guidelines. Make referrals to appropriate staff (Medical Director, Case Manager, Preventive Services, etc.). Ensure... licensure. Preferred: Bachelors in Nursing. 7 years in healthcare program management. Case Manager Certification...
(Medical Director, Case Manager, Preventive Services, Subrogation, Quality of care Referrals, etc.). Participates in data... Management Certification must be obtained within 4 years of hire as a Case Manager. Preferred Education: Bachelor's degree...
and reprocessing actions according to department guidelines. Examines and processes claims and/or non-medical appeals according... and guidelines and refers these to a lead or manager for resolution. Identifies and promptly reports and/or refers suspected...
system, and educate the staff on changes. Assist manager with assignments and special projects. To Qualify...: Knowledge of medical terminology. Knowledge of Medicare Part B regulations/policies/instructions/provisions. Working...
and/or non-medical appeals according to business/contract regulations, internal standards and examining guidelines. Enters claims... be resolved following desk procedures and guidelines and refers these to a lead or manager for resolution. Identifies and promptly...
guidelines. Identify and make referrals to appropriate staff such as Medical Directors, Case Managers, and Quality of Care... management. Preferred Licenses and Certificates: Case Manager Certification, clinical certification in specialty area....
Inspire health. Serve with compassion. Be the difference. Job Summary Reviews medical records to identify..., and hospital quality metrics. Reviews medical records, submits provider queries, and reconciles discharged records. Collaborates...
Director, Case Manager, Preventive Services, Subrogation, Quality of care Referrals, etc.). Participate in data collection... as a Case Manager. Preferred Education Bachelor's degree in Nursing Preferred Work Experience 7 years in healthcare...
. Performs case management responsibilities involved with patient care. This includes, but is not limited to, Utilization Review... as assigned. Supervisory/Management Responsibility This is a non-management job that will report to a supervisor, manager...