- CDM Smith (Sarasota, FL)
- …and construction managers on projects. Coordinates and controls all construction management activities, including critical path method (CPM), scheduling and ... claims administration. Interprets plans and specifications for clients, contractors,...requirements. Performs other duties as required. **Job Title:** Construction Management Professional 7 **Group:** CEI **Employment Type:** Regular **Minimum… more
- Sharecare (Tallahassee, FL)
- …members to Clinical Advocates (Nurse) for conditions that require clinical care and case management assistance + Primary duties include but are not limited ... during the training period will be evaluated on a case by case basis and must be...benefit education, open enrollment / new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management… more
- USAA (Tampa, FL)
- …P&C Litigation Claims Operations and/or Optimization experience. + 2+ years Manager , Claims Operations experience. + Deep operational knowledge of end-to-end ... assistance is not available for this position. **These positions will support Claims Litigations.** **What you'll do:** + Develop and implement strategic customer… more
- Sedgwick (Orlando, FL)
- …from some of the world's most reputable brands + An assigned mentor and manager who will guide you on your career journey + Career development and promotional ... and/or adjustments for client paid leave plans ensuring that on-going claim management is within company service standards and industry best practices. **ARE YOU… more
- CenterWell (Tallahassee, FL)
- …prior experienceparticipatingin teams focusing on transitions of care, quality management ,utilizationmanagement, case management , discharge planning and/or ... of business metrics. + Experience working with Casemanagersor Caremanagerson complex case management , including familiarity with social determinants of health.… more
- Walgreens (Sarasota, FL)
- …strong relationships with most valuable customers, and builds relationship with case managers, nurses and other hospital staff members. **Operations** + Under ... of Conduct. + Performs duties as assigned by Pharmacy Manager , Staff Pharmacist and Store Manager including...those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a… more
- Elevance Health (Miami, FL)
- …on the team in preparation for advancement to the senior level. Within the case management role will within the scope of licensure assess, develop, implement ... The **Transplant Nurse II** will be responsible for providing case and/or medical management for members receiving...a health related field or certification as a care manager preferred. + Knowledge of medical management … more
- Baker Construction (Fort Lauderdale, FL)
- …in establishing clinics, managing first report of injuries, and assisting with co-worker case management + Follows Company Recruitment and Hiring Guidelines + ... job cost summaries, and other reports + Alerts the Superintendent and Project Manager of project impact relating to resource management , crew make-up/size, etc.… more
- Molina Healthcare (Jacksonville, FL)
- …(CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) ... health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies to ensure… more
- Molina Healthcare (Orlando, FL)
- …(CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified Professional ... likelihood of a formal appeal being submitted. * Reevaluates medical claims and associated records independently by applying advanced clinical knowledge, knowledge… more