Director, Healthcare Services - REMOTE Molina Healthcare IncDirector, Healthcare Services - REMOTEWarren, MIRemoteRegistered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). At least 8 years of health care experience, and at least 5 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience.
Remote Registered Nurse (Remote Patient Monitoring & Chronic Care Management) 3:15Remote Registered Nurse (Remote Patient Monitoring & Chronic Care Management)Detroit, MIRemoteAssist patients in the navigation of their healthcare (example - assisting patients with scheduling appointments, coordinating with specialists, and ensuring preventative screenings are completed, etc.). We are looking for a qualified Registered Nurse (RN) to serve our patient population in the navigation, prevention and management of their health through continuous care programs like Remote Patient Monitoring and Chronic Care Management.
Clinical Documentation Specialist Audit Coordinator (Remote) Trinity Health CorporationClinical Documentation Specialist Audit Coordinator (Remote)Livonia, MIRemote$41.43–$62.15 / hourDemonstrates understanding of and facilitates appropriate clinical documentation, to ensure that the medical necessity, severity of illness, risk of mortality, accurate coding, clinical evidence, resources consumed, and level of services provided are accurately reflected in the health record. Responsible for reviewing and/or auditing medical record clinical documentation to support the medical necessity, severity of illness, risk of mortality, accurate coding, clinical evidence, resources consumed, and level of services rendered to all patients.
Coordinator Charge Revenue Integrity - RIO (Remote) Trinity Health CorporationCoordinator Charge Revenue Integrity - RIO (Remote)Livonia, MIRemote$25.02–$37.53 / hourKnowledge of Ambulatory Payment Classification (APC), & Outpatient Prospective Payment System (OPPS) reimbursement structures & prebill edits including Outpatient Coding Edits (OCE)/Correct Coding Initiative (CCI) edits & Discharged Note Final Billed (DNFB). Provides "at-elbow support" to ancillary departments including but not limited to; ensuring supply charges are appropriate captured (may include implants), identify duplicate charges and initiate appropriate communications when there are documentation and/or charge deficiencies or charge errors.
Master Social Worker - Clinical Specialty - Remote BetterHelpMaster Social Worker - Clinical Specialty - RemoteDetroit, MIRemoteAlso, we are unable to accept substance abuse counselors, school counselors, registered nurses, career counselors, Christian counselors, and business coaches (unless they have an additional license as a mental health counselor). BetterHelp is one of the world's largest online therapy platforms for mental health professionals who want to focus on client care — not admin or overhead.
Licensed Psychologist - Remote BetterHelpLicensed Psychologist - RemoteDetroit, MIRemoteAlso, we are unable to accept substance abuse counselors, school counselors, registered nurses, career counselors, Christian counselors, and business coaches (unless they have an additional license as a mental health counselor). BetterHelp is one of the world's largest online therapy platforms for mental health professionals who want to focus on client care — not admin or overhead.
Licensed Marriage and Family Therapist - Remote BetterHelpLicensed Marriage and Family Therapist - RemoteDetroit, MIRemoteAlso, we are unable to accept substance abuse counselors, school counselors, registered nurses, career counselors, Christian counselors, and business coaches (unless they have an additional license as a mental health counselor). BetterHelp is one of the world's largest online therapy platforms for mental health professionals who want to focus on client care — not admin or overhead.
Licensed Professional Counselor - Remote BetterHelpLicensed Professional Counselor - RemoteDetroit, MIRemoteAlso, we are unable to accept substance abuse counselors, school counselors, registered nurses, career counselors, Christian counselors, and business coaches (unless they have an additional license as a mental health counselor). BetterHelp is one of the world's largest online therapy platforms for mental health professionals who want to focus on client care — not admin or overhead.
Coordinator Charge Revenue Integrity - RIO (Remote) Trinity HealthCoordinator Charge Revenue Integrity - RIO (Remote)Livonia, MichiganRemote$25.02–$37.53 / hourKnowledge of Ambulatory Payment Classification (APC), & Outpatient Prospective Payment System (OPPS) reimbursement structures & prebill edits including Outpatient Coding Edits (OCE)/Correct Coding Initiative (CCI) edits & Discharged Note Final Billed (DNFB). Provides “at-elbow support” to ancillary departments including but not limited to; ensuring supply charges are appropriate captured (may include implants), identify duplicate charges and initiate appropriate communications when there are documentation and/or charge deficiencies or charge errors.
Nurse Auditor, Revenue Integrity - (Remote) Trinity HealthNurse Auditor, Revenue Integrity - (Remote)Livonia, MIRemote$31.88–$47.82 / hourNS IV - licensed: Licensed role (direct or indirect healthcare); Provides nursing interventions or clinical knowledge application in decision-making; Participates in the planning, implementation & / or evaluation of & solutions for care; Performs delegated focused / holistic care autonomously according to care plan; May administer medication & carry out the therapeutic treatment within scope of license (state & TH policy); Performs direct & essential care or supportive activities as part of an interdisciplinary team with a deeper understanding, including theoretical knowledge; Demonstrates a level of independence to perform activities with general oversight, through personal contributions, teamwork & initiatives to safely improve outcomes; Advocates for patients & informs / counsels patients & families about illness & care details; May serve as a knowledge resource, role model & mentor or lead / coordinate / supervise direct & essential care activities or role-based service responsibilities of unlicensed / licensed / certified healthcare professionals within licensed scope of practice. Work Focus: Performs clinical care activities (direct or indirect) for patients within the "scope of practice" laws & training received; Cares for patients safely by assisting in clinical care services or engaging in administrative activities (e.g., maintaining records or supplies) that enhance or improve coordination, preparation & flow of the care experience.
**Manager- Outpatient Clinical Documentation Improvement/Full Time/Remote Henry Ford Hospital**Manager- Outpatient Clinical Documentation Improvement/Full Time/RemoteTroy, MIRemoteAs the Outpatient Clinical Documentation (CDI) Manager, you'll lead the strategy, people, and processes behind one of the most critical functions in modern healthcare: ensuring documentation tells the full, accurate story of every patient encounter. Excellent oral and written communication skills, including the ability to teach complex technical/analytical concepts to physicians, system leadership, management and staff.
Clinical Documentation Specialist Audit Coordinator (Remote) Trinity HealthClinical Documentation Specialist Audit Coordinator (Remote)Livonia, MIRemote$41.43–$62.15 / hourDemonstrates understanding of and facilitates appropriate clinical documentation, to ensure that the medical necessity, severity of illness, risk of mortality, accurate coding, clinical evidence, resources consumed, and level of services provided are accurately reflected in the health record. Responsible for reviewing and/or auditing medical record clinical documentation to support the medical necessity, severity of illness, risk of mortality, accurate coding, clinical evidence, resources consumed, and level of services rendered to all patients.
Supervisor, Clinical Documentation Integrity (Remote) Trinity HealthSupervisor, Clinical Documentation Integrity (Remote)Livonia, MichiganRemote$47.23–$70.85 / hourResponsible for scheduling and staffing assignments for the Clinical Documentation Specialist and Clinical Documentation Integrity Coordinator positions, facilitating management of personal time off and schedule change requests, assuring adequate staffing is in place. Works closely with Clinicians, Coding, Quality and Denials teams to facilitate documentation within the medical record and supports the patient’s severity of illness, risk of mortality, clinical validity and proper DRG assignment.
Supervisor, Clinical Documentation Integrity (CDI) - (Remote) Trinity HealthSupervisor, Clinical Documentation Integrity (CDI) - (Remote)Livonia, MIRemote$47.23–$70.85 / hourResponsible for scheduling and staffing assignments for the Clinical Documentation Specialist and Clinical Documentation Integrity Coordinator positions, facilitating management of personal time off and schedule change requests, assuring adequate staffing is in place. Works closely with Clinicians, Coding, Quality and Denials teams to facilitate documentation within the medical record and supports the patient's severity of illness, risk of mortality, clinical validity and proper DRG assignment.
Nurse Auditor, Revenue Integrity - (Remote) Trinity Health CorporationNurse Auditor, Revenue Integrity - (Remote)Livonia, MIRemote$32.52–$48.78 / hourNS IV - licensed: Licensed role (direct or indirect healthcare); Provides nursing interventions or clinical knowledge application in decision-making; Participates in the planning, implementation & / or evaluation of & solutions for care; Performs delegated focused / holistic care autonomously according to care plan; May administer medication & carry out the therapeutic treatment within scope of license (state & TH policy); Performs direct & essential care or supportive activities as part of an interdisciplinary team with a deeper understanding, including theoretical knowledge; Demonstrates a level of independence to perform activities with general oversight, through personal contributions, teamwork & initiatives to safely improve outcomes; Advocates for patients & informs / counsels patients & families about illness & care details; May serve as a knowledge resource, role model & mentor or lead / coordinate / supervise direct & essential care activities or role-based service responsibilities of unlicensed / licensed / certified healthcare professionals within licensed scope of practice. Work Focus: Performs clinical care activities (direct or indirect) for patients within the "scope of practice" laws & training received; Cares for patients safely by assisting in clinical care services or engaging in administrative activities (e.g., maintaining records or supplies) that enhance or improve coordination, preparation & flow of the care experience.
Appeals Registered Nurse Wisconsin Physicians Service Insurance CorpAppeals Registered NurseDetroit, MIRemoteWe are open to remote work in the following approved states: Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin. The Appeals Nurse examines medical records and claims information for first-level appeal cases to determine whether services provided were medically necessary and meet Medicare coverage guidelines in accordance with Medicare regulations and policies.
NewCase Manager-RN Epitec IncCase Manager-RNTroy, MIRemote$36–$39 / hourServing as the primary point of contact for members, caregivers, and providers, this role utilizes telephonic and digital communication channels to assess needs, develop individualized care plans, coordinate services, and improve overall health outcomes across the continuum of care. The Case Manager RN coordinates and leads a multidisciplinary care team to deliver holistic, member-centered care management services for diverse health plan populations with complex medical, behavioral, and social needs.