- AdventHealth (Altamonte Springs, FL)
- …provides primary support for Utilization Management (UM) and secondary support for Care Management (CM) departments and serves as a liaison between UM and ... is responsible for educating, informing and advising members of the Utilization Management , Care Management , Managed Care and Revenue Cycle departments… more
- CenterWell (Jacksonville, FL)
- …partnered Care Integration Team (CIT) resources and programs for transitions of care management (TCM), high-risk patient management (HRPM), and social ... promotion & prevention, disease management , effective specialist & hospital co- management , and complex care management + Spend 20-30% of time on direct… more
- CenterWell (Daytona Beach, FL)
- …partnered Care Integration Team (CIT) resources and programs for transitions of care management (TCM), high-risk patient management (HRPM), and social ... & prevention, disease management , effective specialist & hospital co- management , and complex care management *Spend 20-30% of time on direct patient… more
- Select Medical (Daytona Beach, FL)
- …Preferred qualifications that will make you successful: + Specific experience in Care Management and Discharge Planning is preferred. + Working knowledge ... proper reimbursement for hospital provided services, promote costs attentive care via focus on resource management within the plan of care . + Demonstrates… more
- ChenMed (Orlando, FL)
- …ideally, experience of population risk management or complex chronic disease care management + Effective verbal and written communication skills along with ... of care , providing health education, specialty referrals and case management referrals, providing follow-up care and applying clear, in-depth documentation… more
- Highmark Health (Tallahassee, FL)
- …population health management . **Preferred** + 7 years of experience in managed care , primary care management or other clinical setting. + Experiencein ... in primary care , or healthcare consulting in primary care or population health management . + 3 years of experience in data analysis, interpretation, and… more
- CVS Health (Tallahassee, FL)
- …and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures and regulatory standards ... Management and Utilization Management . AHH delivers flexible medical management services that support cost-effective quality care for members. **Key… more
- US Tech Solutions (Hialeah, FL)
- … care coordination, support and education for members through the use of care management tools and resources. + Conducts comprehensive evaluation of Members ... using care management tools and information/data review + Coordinates and implements assigned care plan activities and monitors care plan progress +… more
- Humana (Tallahassee, FL)
- …and Prescription Drug Plans using approximately 40 measures covering preventive care screenings, health condition management , health outcomes, patient ... is responsible for improving health outcomes and advancing the care experience of our members and provider partners through...if in Louisville area then hybrid The HEDIS Condition Management team is seeking a passionate and organized teammate… more
- Elevance Health (FL)
- …- CareBridge - Bilingual** **Spanish** is responsible for determining the appropriate Care Management program for members referred through internal and external ... triage process and applies established criteria to assign members to appropriate care management component. Deals with least complex cases having limited or no… more