Responsibilities: The MDS Coordinator is responsible for the coordination and completion of clinical assessments, supporting documentation, care planning and transmitting the MDS, as required by federal and state regulations.
*Manage all Medicare/Medicaid case-mix documents at the nursing center to assure appropriate reimbursement for services provided. Overview:
Join the Albuquerque Heights Center as a LPN MDS Coordinator!
Training available
At Genesis Healthcare, we are dedicated to improving the lives we touch through the delivery of high-quality care and exceptional service.
o Bachelor's in Nursing or Certified Professional in Healthcare Quality (CPHQ) o 1 or more years team lead or supervisory experience o 1 year experience in Quality Management o 1 year experience with data analysis and reporting o Experience with InterQual or similar criteria sets o General knowledge of Medicare, Veterans Administration, or other government health care programs. Technical Skills: General knowledge of Medicare, Veterans Administration, or other government health care programs; knowledge in the application of clinical criteria: InterQual, Milliman, PAS-LOS, ICD-9-CM, DSM, CPT-4, and HCPCs; Proficient with Microsoft Word and Excel.
Albuquerque, NM30+ days ago
p>Reporting to the Associate Director of CRTECC, the Education & Outreach Manager works closely with faculty leaders and Community Outreach & Engagement (COE) partners to develop and support cancer career pathway training and education opportunities for New Mexicos unique communities. Its 136 board-certified oncology specialty physicians include cancer surgeons in every specialty (abdominal, thoracic, bone and soft tissue, neurosurgery, genitourinary, gynecology, and head and neck cancers), adult and pediatric hematologists/medical oncologists, gynecologic oncologists, and radiation oncologists.
Albuquerque, New Mexico24 days ago
Responsibilities: The MDS Coordinator is responsible for the coordination and completion of clinical assessments, supporting documentation, care planning and transmitting the MDS, as required by federal and state regulations.
*Manage all Medicare/Medicaid case-mix documents at the nursing center to assure appropriate reimbursement for services provided. Overview:
Join the Ladera Care Center as a LPN MDS Coordinator!
At Genesis Healthcare, we are dedicated to improving the lives we touch through the delivery of high-quality care and exceptional service.
Technical Skills: Knowledge of TRICARE policies and procedures, knowledge of Case Management, Utilization Management, and Quality Management practices and principles, and knowledge of Managed Care concepts, alternative care treatments, and community resources. ā¢ Research and investigate medical issues as they relate to potential fraud and abuse cases, to include perform anti-fraud and abuse pre-payment reviews or post-payment reviews.
Case Manager Encompass Health Rehabilitation Hospital of Albuquerque
Case ManagerAlbuquerque, NM5 days ago
Join Encompass Health, where being a Case Manager goes beyond just a job; it positions you as a vital link between exceptional care and the transformative impact on each patient's journey. Our achievements include being named one of the "World's Most Admired Companies" and receiving the Fortune 100 Best Companies to Work ForĀ® Award, among other accolades, which is nothing short of amazing.
li>Career Transition Assistance Program (CTAP)/Interagency Career Transition Assistance Program (ICTAP): If you are claiming CTAP/ICTAP, follow the instructions below: http://www.opm.gov/policy-data-oversight/workforce-restructuring/employee-guide-to-career-transition/ctap_guideline.pdf. A Bachelors or graduate/higher level degree from an accredited college/university, including 16 semester hours (24 quarter hours) of biological science (with one semester in microbiology), 16 semester hours (24 quarter hours) of chemistry (with one semester in organic or biochemistry), one semester (one quarter) of mathematics, AND five (5) years of full time acceptable clinical laboratory experience in Blood Banking, Chemistry, Hematology, microbiology, Immunology and Urinalysis/Body Fluids.
Albuquerque, NM30+ days ago
p>Matrix Providers is hiring a Registered Nurse - Case Managerto join our team of talented professionals who provide health care services to our Military Service Members and their families in at Kirtland Air Force Base in Albuquerque, NM. Coordination: Ensure coordination of care delivery processes, to include alternate healthcare settings and the home environment, for the purposes of enhancing the patientās health and wellness, safety, productivity, and quality of life, and for providing the most beneficial, cost-effective health care.
Albuquerque, NM30+ days ago
p>PURPOSE AND SCOPE: Manages the provision of quality patient care in an independent home therapy program while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory requirements and programs.
Frequently interacts with supervisors, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers.
Albuquerque, NM30+ days ago
It is Siemens Healthineers' policy to comply fully and completely with all United States export control laws and regulations, including those implemented by the Department of Commerce through the Export Administration Regulations (EAR), by the Department of State through the International Traffic in Arms Regulations (ITAR), and by the Treasury Department through the Office of Foreign Assets Control (OFAC) sanctions regulations.". As a Project Manager supporting Imaging Systems, you will oversee logistics, planning, delivery, and installation activities for imaging equipment across multiple modalities, including MR, CT, X-Ray, and advanced diagnostic systems.
Following regulatory approval, the Rare Disease Business Manager will play a key role in generating demand for a new therapeutic option by focusing on educating and informing healthcare professionals by providing clinical information and in-depth knowledge of the product, the orexin system, and narcolepsy type 1. This role involves collaboration with their Regional Business Leader and other cross-functional, customer-facing teams to ensure healthcare providers (HCPs) are well educated and that appropriate patients have access to a new therapeutic option, once approved by federal agencies.
Albuquerque, NM30+ days ago
p>Under the direct clinical supervision of the site Clinical Supervisor and with administrative direction from the Health Center Manager, coordinates clinical staffing to ensure the efficient flow of patients through the Health Center and assists providers in delivering quality patient care, to include administration of injections, medical treatments, patient education, coordination of care, and other clinical activities.
Albuquerque, NM30+ days ago
Walgreens has approximately 220,000 team members, including nearly 90,000 healthcare service providers, and is committed to being the first choice for pharmacy, retail and health services, building trusted relationships that create healthier futures for customers, patients, team members and communities. Models and shares customer service best practices with all team members to deliver a distinctive and joyful patient experience, including interpersonal habits that show care (e.g., greeting, eye contact, courtesy, etc.) and Walgreens service traits (e.g., demonstrating curiosity to identify needs and proactively helping, servicing until satisfied, championing empathy and inclusivity, etc.).
Albuquerque, NM30+ days ago
li>The Case Manager shall collect, organize, record, and communicate data relevant to primary health assessments including a detailed medical history in order to develop time sensitive treatment plans which delineate the expected process of care delivery for selected case managed patients or populations. - The Nurse Case Manager, hereafter referred to as the Case Manager, shall provide a full range of professional health nursing principles, practices, and procedures in clinical settings in order to analyze the full scope of problems associated with providing appropriate, cost effective care to Department of Defense (DOD) beneficiaries.
The Program Manager, Strategic Performance Excellence supports the development and execution of Corrective Action Plans (CAPs) in response to government-issued Corrective Action Requests (CARs) across the TRICARE (T-5) and Community Care Network (CCN) programs. In addition, this role partners with the Quality Performance Improvement team to integrate preventive insights and leading indicators from Quality Improvement Plans into project plans, timelines, and reporting to help mitigate risks before they escalate.
Albuquerque, New Mexico24 days ago
The team runs a high-volume outbound contact center ā activating members, conducting outreach campaigns, and driving engagement ā alongside a lower-volume, higher-complexity layer of care navigation work: closing care gaps and coordinating follow-through on health-related needs. This is a role for an experienced contact center operator who understands value-based care outcomes ā someone who can run a real-time outbound operation at scale while keeping the team focused on the quality metrics that drive member success.
p>GS-06: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-05 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: providing routine direct patient care and clinical support services as part of an interdisciplinary healthcare team; performing patient intake, screening, data collection, vital signs, routine testing, and documentation in electronic health records in accordance with established procedures; preparing patients for examinations and procedures and supporting patient comfort, safety, and mobility; monitoring, evaluating, and documenting patient conditions and recognizing and reporting significant or subtle changes requiring clinical attention; performing authorized testing and monitoring activities in accordance with established protocols; and maintaining accurate patient care documentation while ensuring compliance with privacy, confidentiality, and infection control requirements. MINIMUM QUALIFICATIONS:
GS-05: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-04 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: providing basic clinical and clerical support in a healthcare setting under supervision; conducting patient screening, obtaining and recording vital signs, and documenting patient information in electronic health records; assisting with patient positioning, activities of daily living, and routine clinical procedures to support patient comfort and safety; recognizing and reporting changes in patient condition; maintaining exam rooms, supplies, and equipment in accordance with infection control and safety guidelines; and performing administrative support duties such as scheduling appointments, maintaining records, and coordinating communications with healthcare staff and external facilities.
p>Arrowhead Pharmaceuticals is seeking a strategically minded, relationship-driven Key Account Manager (KAM) to lead enterprise engagement across priority health systems, Integrated Delivery Networks (IDNs), and complex accounts within an assigned geography. This individual will establish Arrowhead as a trusted partner to health systems by embedding Plozasiran into clinical pathways, supporting formulary access, and ensuring seamless coordination between system-level strategy and field prescriber activation.
Rio Rancho, New Mexico30+ days ago
We distinguish ourselves through our commitment to excellence, to our patients, to our employees, and to the communities we serve.The HIM Manager is responsible for maintaining the security, confidentiality, completeness, and accuracy of medical records in accordance with policies and procedures and within the guidelines of regulatory agencies.
Safeguards the confidentiality of all medical records by ensuring the Release of Information policy is followed in accordance with HIPAA and other requirements; securing legal/risk management records; responding timely to subpoenas and/or court orders; and representing the hospital in court hearings and/or depositions as required.
Albuquerque, NM30+ days ago
li>Ensures each Tier 1, Tier 2 and Tier 3 provider has quality & risk adjustment performance goals and execution plans to meet committed goals, with emphasis on Tier 1 and Tier 2. Drives provider partner coaching and collaboration to improve quality performance and risk adjustment accuracy through consistent provider meetings, action item development and execution. Is a Provider Engagement subject matter expert; works collaboratively within the Health Plan and across Molinas Centers of Excellence and Shared Services to drive improved risk adjustment and quality of care.
Albuquerque, NM30+ days ago
Albuquerque, NM30+ days ago
The ideal candidate will have experience serving high-risk populations, including those impacted by poverty, mental and behavioral health challenges, substance use disorders, and social determinants of health, and will be deeply committed to enhancing family well-being through the NFP model. Assess and respond to the complex needs of families experiencing mental health challenges, substance use, domestic violence, housing instability, or other high-risk circumstances, providing trauma-informed and culturally responsive care.
Essential responsibilities and duties may include, but are not limited to, the following: - Demonstrate selling skills and pull-thru execution through strategically and tactically allocating resources to drives results. We are committed to building diverse teams, representative of the patients and communities we serve, and we strive to create an inclusive workplace that cultivates collaboration.