- HCA Healthcare (Tallahassee, FL)
- …next step in your career path, we encourage you to apply for our Manager Case Management opening. We review all applications. Qualified candidates will be ... Do you have the career opportunities as a(an) Manager Case Management you want in your current...Performs admission certification screening for patients in accordance with Utilization Plan using ISD criteria, and performs concurrent stay… more
- HCA Healthcare (Pensacola, FL)
- …assessment of psychosocial and medical needs of assigned patients. + Develops a case management plan of care to include identified clinical, psychosocial, ... agencies. + Documents professional recommendations, care coordination interventions, and case management activities toeffectivecommunicatetoall members of the… more
- CVS Health (Tallahassee, FL)
- …within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers ... overcome barriers to meeting goals and objectives. + Utilizes case management processes in compliance with regulatory...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- HCA Healthcare (Kissimmee, FL)
- …resource utilization . What you will do in this role: + Develops a case management plan of care to include identified clinical, psychosocial and discharge ... agencies + Documents professional recommendations, care coordination interventions, and case management activities to effectively communicate to...growth, we encourage you to apply for our RN Case Manager opening. We promptly review all… more
- Adecco US, Inc. (Altamonte Springs, FL)
- …Previous experience in an acute clinical care setting or equivalent. . Previous care management , utilization review or discharge planning experience. . RN ... Healthcare & Life Sciences is looking for an **RN Case Manager** for our client in **Altamonte Springs, FL**...thorough understanding of the cost consequences resulting from Care Management decisions through utilization of reports and… more
- AdventHealth (Daytona Beach, FL)
- …Finance & Decision Support. Serves as regional executive liaison with Revenue Cycle, Utilization Review , Case Management , Supply Chain, Managed ... Oversee functions directed by centralized division services such as Patient Access, Utilization Review , Case Management , Patient Financial Services, HIM,… more
- HCA Healthcare (Kissimmee, FL)
- …patient throughput while supporting a balance of optimal care and appropriate resource utilization . + Provides case management services for both inpatient ... appropriate referrals to third party payer and disease and case management programs for recurring patients and...growth, we encourage you to apply for our RN Case Manager opening. We promptly review all… more
- Elevance Health (Tampa, FL)
- …area to refer or assign case ( utilization management , case management , QI, Med Review ). + Provides information regarding network providers ... Gathers clinical information regarding case and determines appropriate...and documents all actions. + Responsibilities exclude conducting any utilization management review activities which… more
- Elevance Health (Tampa, FL)
- …to work East Coast time zone hours.** The **Medical Director** will be responsible for utilization review case management for Commercial business in the ... and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers...state or territory of the United States when conducting utilization review or an appeals consideration and… more
- Elevance Health (Tampa, FL)
- …is providing services in multiple states. **Preferred Capabilities, Skills and Experiences:** + Case Management experience. + Certification as a Case ... assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of… more