- WestCare Foundation (Miami, FL)
- …assigned. Qualifications Essential Qualifications: Certifications/Licensures: + Certification as a certified case manager in good standing and recognized by the ... Service Plans in collaboration with the consumer and family + Conduct monthly Service Plan reviews + Document all clinical services and activities in accord… more
- AdventHealth (Minneola, FL)
- …health setting and critical care **LICENSURE, CERTIFICATION, OR REGISTRATION PREFERRED:** + Case Management certification Accredited Case Manager (ACM) + ... 204,000 square feet, the hospital will include an emergency department; full- service imaging; five operating suites; endoscopy services ; outpatient laboratory;… more
- Deloitte (Tampa, FL)
- …and technology solutions for large cross industry clients. They focus primarily on client service delivery but also drive sales activities and thought leadership ... technology & data platforms. Our delivery models are tailored to meet each client 's unique requirements. Recruiting for this role ends 10/15/2025 Work You'll Do +… more
- Elevance Health (FL)
- …and providers. **How you will make an impact:** + Perform physician-level case review, following initial nurse review, of Medical Oncology regimens and supportive ... care. + Perform physician-level case review, following initial nurse review, of chemotherapy regimens....+ Determine medical necessity of requests using guidelines and client -specific health plan medical policy. + Conduct peer-to-peer discussions… more
- SitusAMC (Tallahassee, FL)
- …use and support of the ProMerit technology platform, warehouse financing operational activities, client services , presentation skills & ability to take on other ... client and internal documentation + Manage time to Service Level Agreements agreed to with client ...+ Other activities as may be assigned by your manager Qualifications/ Requirements: + Bachelor's degree or equivalent from… more
- CBRE (Tallahassee, FL)
- HSE Global Contract Safety Specialist Job ID 237537 Posted 29-Sep-2025 Service line GWS Segment Role type Full-time Areas of Interest Health and Safety/Environment ... CBRE's compliance in third party systems in line with client requirements, and for contractors of CBRE in CBRE's...will report to the Global Governance and Assurance Sr. Manager and a part of the Global HSE Platform… more
- Elevance Health (Miami, FL)
- …director provides clinical expertise in all aspects of utilization review and case management. Provides input on the clinical relevance to account reporting ... regarding use of medical services by members. Involved in identifying and managing medical...trends, emerging trends and market changes that impact the client and members. Responsible for proactively identifying and solutioning… more
- Elevance Health (Miami, FL)
- …**How you will make an impact:** + Ensures timely completion of clinical case reviews for their board certified specialty. + Makes physician to physician calls ... appropriate information in order to make medical necessity determinations for services requested. + Makes medical necessity determinations for grievance and appeals… more
- CDM Smith (Tallahassee, FL)
- …* Oversees groups operations including staffing, quality, profitability, sales support and client service . * Monitors business operations through monthly reviews ... international regulatory laws for reporting, addressing any non-compliance. * Collaborates with Client Service Units, oversees, directs, and ensures a balanced… more
- Datavant (Tallahassee, FL)
- …handling and releasing Protected Health Information (PHI). + Monitor adherence to client -specific service -level agreements (SLAs) and protocols. + **Training & ... Perform quality checks to ensure compliance with HIPAA, state/federal laws, client -specific requirements, and invoicing standards. + Identify workflow issues, error… more