- Determine strength documentation criteria appeal If case viable attempt peer peer send written appeal if lacking downgrade lower care Adjust level care eg NICU levels ICU levels
- Maintain working relationship payers via periodic discussions medical necessity Implement CMS Form process help mitigate MA medical necessity denials Send beneficiary appeals grievances Maintain contact CHA Payer Audit Representatives Meeting Periodically review CMS manual re: MA plans keep updated national commercial CMS denial issues RAC Relief RAC summit Modern Healthcare Beckers Medical Economics Keckley Report RAC Monitor etc Pursue/follow State Insurance Commissioner AHA compile issues Review Medicare one-day length stay cases possible addendum Assistant Hospitalist Director DH/NH JK CM recommend possible adjustment provider liable Provide education new Hospitalists employment UR processes IP OP CC44 DM processes documentation peer p
This position also involves maintaining working relationships with various departments implementing procedures to reduce unnecessary hospital stays.We require someone who can do this successfully -
We are seeking a driven individual that is motivated by client satisfaction and continued success. · 100% client amazement and loyalty · Interact with clients in a friendly and professional manner at all times creating a memorable experience. · ...
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Hospital Operations Manager - Danbury - beBeeDenialManagement
Job title: Medical Director Denial Management
Description
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Operations Manager
Only for registered members Danbury
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Operational Excellence Manager
Only for registered members Danbury
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Operations Manager, Danbury
Only for registered members Danbury
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Operational Excellence Manager
Only for registered members Danbury, CT
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Project Manager – Operational Excellence
Full time Only for registered members Danbury
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Project Manager – Operational Excellence
Only for registered members Danbury
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Senior Manager, People Operations
Only for registered members Danbury
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Project Manager – Operational Excellence
Only for registered members Danbury, CT
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Senior Manager, People Operations
Only for registered members Connecticut, Danbury
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Project Manager – Operational Excellence
Only for registered members Danbury, CT
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Senior Manager, People Operations
Only for registered members Connecticut, Danbury
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Manager, Logistics and Warehouse Operations
Only for registered members Danbury, CT,
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Project Manager – Operational Excellence
Only for registered members Danbury, CT
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Branch Operations Manager
Only for registered members Bethel, Connecticut, , United States
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Operations Manager and Moving Brookfield CT
Only for registered members Danbury
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Operations Manager
Only for registered members North Salem
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Operations Manager
Only for registered members Rocky Hill, CT
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Operations Manager
Only for registered members Newtown, CT
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Operations Manager
Only for registered members North Salem, NY
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Operations Manager
Only for registered members Newtown
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Operations Manager
Only for registered members Ridgefield, CT