- CenterWell (Jacksonville, FL)
- …performance in patient experience, quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify opportunities ... our primary care team, combining clinical practice with leadership and operational management to ensure high-quality patient care and alignment with Value-Based Care… more
- CenterWell (Daytona Beach, FL)
- …in patient experience, quality of care, clinical outcomes, and avoidable utilization *Periodically review clinician charts to identify opportunities in ... our primary care team, combining clinical practice with leadership and operational management to ensure high-quality patient care and alignment with Value-Based Care… more
- HCA Healthcare (Kissimmee, FL)
- …patient placement through clinical screenings and assessments in collaboration with both hospital Case Management and the Rehab Medical Director. Job Duties and ... + Functions as primary contact for external and internal case management and referring physician. Establishes and...commitments to referral sources. Develops a call-plan to prioritize utilization of time. + Assists in developing the annual… more
- MyFlorida (Orlando, FL)
- …Administration (HRSA) grant. This position is responsible for providing unique, specialized case management services to pregnant women; parents of at-risk ... or a mutually agreed upon location to assist with continuity of care. Provides case management services through home visitations to pregnant women; parents of… more
- MyFlorida (Orlando, FL)
- …Child Safety Risk Assessment is completed within the prescribed timeframes. Print and review all abuse reports received from the Hotline and OTI requests called in ... (FAHIS), Child Information System (CIS) and Florida Safe Families Network (FSFN). Review appropriate databases for the previous or open investigations and child… more
- Elevance Health (Miami, FL)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... role required by a State agency. **Preferred Skills, Capabilities, and Experiences:** + Utilization Management experience is a plus. + Ability to meet necessary… more
- Prime Therapeutics (Tallahassee, FL)
- …of post-degree clinical experience. + Experience in managed care, specialty drugs, care management and utilization review . + Meets Credentialing criteria. + ... for drug services. + Will actively maintain a required case load and the activities to reach overall goals...appeals program. + Participates in meetings and consults with management on regular basis to discuss member interaction and… more
- AdventHealth (Winter Park, FL)
- …an RN *Acute care experience *Prior leadership experience *Experience in Case Management , Managed Care, Discharge Planning and Utilization Management * ... our patient population. The Expeditor partners with physicians and providers, care management team, nursing teams, and support service teams to facilitate patient… more
- CVS Health (Tallahassee, FL)
- …will review prior claims to address potential impact on current case management and eligibility status. Focus assessments and/or questionnaires are designed ... impact on our members, who are enrolled in Care Management and present with a wide range of complex...community. - Utilizes weekly and daily reporting to identify utilization for the purpose of reducing Emergency Department … more
- CVS Health (Tallahassee, FL)
- …will review prior claims to address potential impact on current case management and eligibility status. Focus assessments and/or questionnaires are designed ... impact on our members, who are enrolled in Care Management and present with a wide range of complex...community + Utilizes weekly and daily reporting to identify utilization for the purpose of reducing Emergency Department … more