Case Manager Jobs in Rancho Cordova
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Search Results - Case Manager Jobs in Rancho Cordova
Blue Shield of California-Rancho Cordova
Your Role
Work schedule is Mon-Fri 10am- 7pm
The Federal Employee Program (FEP) team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating...
Aditi Consulting-Rancho Cordova
Summary:
The main function of a Case Manager is to organize and facilitate patient care and work with healthcare providers to ensure patients receive necessary services. This includes assessing patient needs, evaluating treatment options...
resume-library.com -
Blue Shield of California-Rancho Cordova
or advanced degree preferred
• Certified Case Manager (CCM) Certification or is in process of completing certification when eligible based on CCM application requirements
• Requires at least 5 years of prior experience in nursing, healthcare or related field...
MMC Group-Rancho Cordova
refer callers to the appropriate case manager or career development specialist for service.
• Performs data entry, as caller is providing information over the phone, in accordance with established individual objectives and defined quality levels...
smartsearchonline.com -
Blue Shield of California-Rancho Cordova
with state, federal and accreditation requirements
• Ensures proper procedure codes and diagnosis codes are reviewed for submitted procedures/claims appeal
• Initiates referrals for members to Case Management as needs are identified
Your Knowledge...
Rancho Cordova
is a leading provider of innovative healthcare services including independent medical examinations, peer reviews, bill reviews, Medicare compliance, case management, record retrieval, document management and related services.
Our clients include property...
icims.com -
Blue Shield of California-Rancho Cordova
service or treatment delays and intervenes or as clinically appropriate
• Refer to Case Management when there are acute inpatient needs affecting discharge
• Attend staff meetings, clinical rounds and weekly huddles
• Maintain quality and productivity...
Rancho Cordova
peer reviews, bill reviews, Medicare compliance, case management, record retrieval, document management and related services. Our clients include property and casualty insurance carriers, law firms, third-party claim administrators and government...
icims.com -
Blue Shield of California-Rancho Cordova
appropriate
• Provides referrals to Case Management, Disease Management, Appeals and Grievance, and Quality Departments as necessary
• Attend staff meetings, clinical rounds and weekly huddles
• Maintain quality and productivity metrics for all casework...
Rancho Cordova
psychiatric nursing and/or case management experience preferred.
• Master's degree in Nursing (MSN) or related field preferred.
#carecoordination
#LI-DH...
icims.com -
Blue Shield of California-Rancho Cordova
Appeals/Grievances, Case Management/Population Health, Education/Training (delivers CME, CEU), Quality Improvement
Pay Range:
The pay range for this role is: $ 209091.00 to $ 330000.00 for California.
Note:
Please note that this range represents...
Rancho Cordova
healthcare services including independent medical examinations, peer reviews, bill reviews, Medicare compliance, case management, record retrieval, document management and related services. Our clients include property and casualty insurance carriers, law...
icims.com -
Blue Shield of California-Rancho Cordova
or as clinically appropriate
• Triages and prioritizes cases to meet required turn-around times and expedites access to appropriate care for members with urgent needs
• Provides referrals to Case Management, Disease Management, Appeals and Grievance and Quality...
Blue Shield of California-Rancho Cordova
for case management triage and research member eligibility/benefits and provider networks
• Assign initial EOA days, or triage to nurses, based on established workflow
• Assist with audit file prep
• Collaborate with team members on difficult cases...
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