- CenterWell (Jacksonville, FL)
- …coaching initiatives are precise + Identify critical issues for high-risk patients during case reviews & other forums, and modeling and driving clinical excellence + ... indicators (KPIs), such patient experience via Net Promoter Score (NPS) and Medicare clinical quality via HEDIS, meeting local and organizational goals + Personally… more
- Elevance Health (Tampa, FL)
- …duties may include, but are not limited to: + Gathers clinical information regarding case and determines appropriate area to refer or assign case (utilization ... Capabilities and Experiences** : + Understanding of managed care or Medicaid/ Medicare strongly preferred. + Ability to obtain Florida Fingerprinting assessment,… more
- Banner Health (FL)
- …of accounts for specific patient types and specialties in combination with the Case Mix Index and case financial information to formulate productivity standards, ... both the Banner Coding Education team and your hiring manager , with continued support throughout your career here! _*This...to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG)… more
- AdventHealth (Davenport, FL)
- …including but not limited to: Coordination of Care, Centers for Medicare & Medicaid Services (CMS) Conditions of Participation, Discharge Planning, Social ... of Stay, Excess days, Avoidable Days, Value Based Care partnerships, Care Manager 's roles in Multidisciplinary Rounds, Care Transitions, team member engagement, team… more
- AdventHealth (Tampa, FL)
- …including but not limited to: Coordination of Care, Centers for Medicare & Medicaid Services (CMS) Conditions of Participation, Discharge Planning, Social ... of Stay, Excess days, Avoidable Days, Value Based Care partnerships, Care Manager 's roles in Multidisciplinary Rounds, Care Transitions, team member engagement, team… more
- Humana (Belle Glade, FL)
- …as ordered on patient plan of care. Report's problems/potential problems to RN/ Case Manager .forward and of moderate complexity. The Licensed Practical Nurse ... unusual symptoms and/or changes in condition of clients. Participate in case conferences, meeting and performance improvement activities as assigned. Provides proof… more
- Molina Healthcare (St. Petersburg, FL)
- …that involve clinical HCS staff. Communicates findings to the Supervisor or Manager , HCS Department for resolution. + Maintains a minimal caseload as determined ... guidelines and support staff who have an ongoing member case load for regular outreach and management. + As...staff workload for adherence to the Policies, Procedures, Guidelines, Medicare Model of Care, and deadlines. Assures oversight and… more
- HCA Healthcare (Fort Walton Beach, FL)
- …patients with discharge planning or psychosocial needs. + Obtains input from the RN case manager to ensure the discharge plan is appropriate and aligns with ... maintains a thorough working knowledge of the rules of Medicare , Medicaid, and private payer regulations and processes, and...do in this role: + Works collaboratively with RN case managers, acute care nurses, physicians, insurance companies, and… more
- AdventHealth (Minneola, FL)
- …including but not limited to: Coordination of Care, Centers for Medicare & Medicaid Services (CMS) Conditions of Participation, Discharge Planning, Social ... of Stay, Excess days, Avoidable Days, Value Based Care partnerships, Care Manager 's roles in Multidisciplinary Rounds, Care Transitions, team member engagement, team… more
- Humana (Miramar, FL)
- …consistently + Communicates and coordinates referrals with outside sources, such as case : managers, nursing agencies and Dr's offices personnel + Assists the ... and business needs + Additional responsibilities as assigned by the manager or Pharmacist-In-Charge **Regulatory Requirements** + One (1) year related pharmacy… more