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The Carpenter Funds Administrative Office of Northern California, Inc.

Oakland, California

South Plains Rehabilitation Hospital, an affiliate of UMC and Encompass Health Logo
South Plains Rehabilitation Hospital, an affiliate of UMC and Encompass Health

Lubbock, Texas

Laredo Technical Services, Inc.

Pyongtaek, South Korea

Adkisson Search Consultants

Hopkinsville, Kentucky

MultiCare Health System Logo
MultiCare Health System

Auburn, Washington

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AdventHealth

Shawnee Mission, Kansas

Veterans Affairs, Veterans Health Administration Logo
Veterans Affairs, Veterans Health Administration

Pueblo, Colorado

Kindred Hospitals Logo
Kindred Hospitals

Madison, New Jersey

Veterans Affairs, Veterans Health Administration Logo
Veterans Affairs, Veterans Health Administration

San Francisco, California

Veterans Affairs, Veterans Health Administration Logo
Veterans Affairs, Veterans Health Administration

Alexandria, Louisiana

Veterans Affairs, Veterans Health Administration Logo
Veterans Affairs, Veterans Health Administration

Bay Pines, Florida

Stanford Children's Health - Lucile Packard Children's Hospital Logo
Stanford Children's Health - Lucile Packard Children's Hospital

Palo Alto, California

Veterans Affairs, Veterans Health Administration Logo
Veterans Affairs, Veterans Health Administration

Houston, Texas

Veterans Affairs, Veterans Health Administration Logo
Veterans Affairs, Veterans Health Administration

Little Rock, Arkansas

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Baylor Scott & White Health

Irving, Texas

Community Medical Centers Inc. Logo
Community Medical Centers Inc.

California

Stanford Children's Health - Lucile Packard Children's Hospital Logo
Stanford Children's Health - Lucile Packard Children's Hospital

Palo Alto, California

Veterans Affairs, Veterans Health Administration Logo
Veterans Affairs, Veterans Health Administration

Houston, Texas

Veterans Affairs, Veterans Health Administration Logo
Veterans Affairs, Veterans Health Administration

Martinez, California

Veterans Affairs, Veterans Health Administration Logo
Veterans Affairs, Veterans Health Administration

Saint Cloud, Minnesota

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Care Manager Clinical Denials
JOB SUMMARY: The Care Manager Clinical Denials (CM-CD) is responsible for the management of clinical audits and denials related to inpatient medical necessity and/or level of care, and coding. The CM-CD reviews patient medical records and all other pertinent patient information, and applies clinical and regulatory knowledge, screening criteria and judgment, as well as knowledge of payor requirements and denial reason codes/rationale, to determine why cases are denied and whether an appeal is required. For all inappropriate denials, relevant information is submitted, according to each payor's appeal timeframes, through denial management tracking software with bi-directional interface with physician advisor appeal coordination and follow-up. The CM-CD serves as


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