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Gainwell Technologies LLC
Overview
The DRG Nurse Reviewer Appeals and Hearings coordinates and performs all appeal-related duties, including analyzing and responding to provider appeals and preparing case files for hearings. The role also involves participating in hearings and assisting in training new reviewers.
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Compensation
$90,000 - $99,000 / YEAR
Posted
8 days ago
Destiny Management Services LL
The PEBLO serves as a liaison for the medical treatment facility, providing guidance on the Disability Evaluation System and coordinating various medical and administrative processes. They are responsible for tracking cases, advising service members, and ensuring compliance with regulatory requirements.
Salary not listed
1 month ago
Stanford Health Care Tri-Valley
The Case Manager reviews medical information to provide clinical justification for admissions and coordinates patient care plans across the healthcare team. They also manage utilization review activities, facilitate the appeals process for denials, and coordinate discharge planning for high-risk patients.
$71 - $95 / HOUR
UHS
The UR Coordinator manages patient treatment activities, including clinical screenings, treatment plan establishment, and discharge planning. They also coordinate with insurance companies and third-party reviewers to secure precertification and manage the appeals process.
A&I Avenues
The Children's Case Manager is responsible for developing and implementing service plans for clients aged 0-21, including conducting eligibility assessments and monitoring service quality. They also coordinate care with families and providers while ensuring all documentation meets regulatory and funding requirements.
$23 / HOUR
Lifescape Community Services
The Case Manager/Care Coordinator assesses, authorizes, and manages Community Care Program (CCP) services while providing ongoing case management to eligible participants across four counties. This role involves conducting community-based assessments, developing Person-Centered Plans of Care, arranging service implementation with vendors, and ensuring compliance with Illinois Department on Aging regulations.
2 months ago
Care Synergy
The coordinator manages the scheduling, logistics, and documentation for all Interdisciplinary Team (IDT) meetings, including assessments and care plan reviews, ensuring all documentation accurately reflects consensus and meets CMS and state regulatory standards. They also monitor service provision adherence, communicate the final Plan of Care to relevant staff and providers, and foster vigilance within the IDT for recognizing triggers for necessary care plan revisions.
$25 - $30 / HOUR
3 months ago
