- BayCare Health System (Riverview, FL)
- … services. + Serves the hospital through teaching, consulting, and advising the care management and utilization review departments and the hospital leadership. + ... of care provided. + Works with hospital leadership in developing care management protocols with physicians and others to optimize length of hospital stay and… more
- CVS Health (Orlando, FL)
- …and Brevard counties. The BH CCM , is responsible for driving and supporting care management and care coordination activities across the continuum of ... for telephonic and/or face to face assessment, planning, implementing and coordinating care management activities with members to ensure that their medical… more
- AdventHealth (Orange City, FL)
- …The Clinical Social Worker, Licensed, is under the general supervision of the Care Management Supervisor or Manager and is responsible for patient evaluations ... the guardianship (temporary/ permanent) policies and procedures and coordinates with Care Management leadership throughout the process. + Provides consultation… more
- CVS Health (Inverness, FL)
- … care coordination, support and education for members through the use of care management tools and resources. Evaluation of Members: -Through the use of ... care management tools and information/data review, conducts comprehensive evaluation of referred members' needs/eligibility and recommends an approach to case… more
- US Tech Solutions (Miami, 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
- Datavant (Tallahassee, FL)
- …aligned to customer outcomes, regulatory drivers, and market trends in risk adjustment, care management , and provider enablement. + Identify and prioritize use ... standards (FHIR, HL7, APIs) to enable seamless enablement with EHRs, care management platforms, and third party integrations. + Balance innovation with… more
- AdventHealth (New Smyrna Beach, FL)
- … escalations. The Social Work Specialist is under the general supervision of the Care Management Supervisor or Manager and is responsible for patient evaluations ... social work. **Preferred qualification:** + Master's in social work. + Care Management discharge planning experience. + Knowledge of state and federal guidelines… more
- Molina Healthcare (St. Petersburg, FL)
- …also include but not limited to, collaborate with CM Leadership ensuring the Care Management Monitoring Tool (CMMT) is run every workday and cases ... practice with managed care , hospital nursing, utilization and/or care management experience. **Preferred License, Certification, Association** Active,… more
- AdventHealth (Orlando, FL)
- …The Clinical Social Worker, Licensed, is under the general supervision of the Care Management Supervisor or Manager and is responsible for patient evaluations ... Work (MSW) + 5 experience in hospital/medical social work + Care Management discharge planning experience + LCSW- License Clinical Social Worker **Preferred:**… more
- AdventHealth (Maitland, FL)
- …to accounts receivable, utilization management , quality assurance, billing, pre-access, care management , and other related issues through application of ... tier payer contracts. Duties as assigned include leading strategic managed care contracting initiatives as directed by AdventHealth leadership; managed care… more