- Centene Corporation (Tallahassee, FL)
- …physician education with respect to clinical issues and policies. + Identifies utilization review studies and evaluates adverse trends in utilization of ... management, cost containment, and medical quality improvement activities. + Performs medical review activities pertaining to utilization review , quality… more
- HCA Healthcare (Gainesville, FL)
- …a data-driven environment of quality and cost improvement and develops systems to review utilization of resources and objectively measure outcomes of care ... for appeals and denials process, discharge planning, case management, and utilization review /management. + Consults with facility-level staff regarding delegated… more
- CVS Health (Tallahassee, FL)
- …ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions ... Standard Time (EST)_** _._ Help us elevate our member care to a whole new level! Join our Aetna...serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our… more
- BAYADA Home Health Care (Jacksonville, FL)
- … clinical and administrative operations, including staff supervision, patient care coordination, budgeting, and resource allocation. + Ensure the agency maintains ... with purpose in a dynamic and growing healthcare field? **Baptist Home Health Care by BAYADA** is seeking an experienced and compassionate **Director** to manage… more
- Veterans Affairs, Veterans Health Administration (Sebring, FL)
- …approved ACGME or equivalent residency required The physician will have significant experience clinical experience in primary care , or equivalent clinical ... Summary The Bay pines VA Healthcare System's Primary Care Service is seeking an experienced and dynamic...the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible… more
- AdventHealth (Deland, FL)
- …Manager ensures efficient and cost-effective care through appropriate resources monitoring, and clinical care escalations. The RN Care Manager is under ... (as permitted by the patient) as well as a review of the current and past inpatient and outpatient...BSN + Health-related Master's degree or MSN + Prior Care Management/ Utilization Management experience ACM/CCM Certification This… more
- AdventHealth (Deland, FL)
- …Manager ensures efficient and cost-effective care through appropriate resources monitoring, and clinical care escalations. The RN Care Manager is under ... (as permitted by the patient) as well as a review of the current and past inpatient and outpatient...BSN + Health-related Master's degree or MSN + Prior Care Management/ Utilization Management experience ACM/CCM Certification This… more
- AdventHealth (Altamonte Springs, FL)
- …at I) the Walt Disney Pavilion, 2) All AdventHealth Orlando ("AHO") departments providing clinical care to children (0-17), and 3) AHFC Network locations. + ... between Medical Staff leadership and AHFC, and spearheading the integration of pediatric care and clinical quality standards across all AHFC Network locations.… more
- AdventHealth (Winter Park, FL)
- …an active role in educating nursing and care management on patient care management from a clinical progression standpoint. *Maintains knowledge of federal ... experience *Prior leadership experience *Experience in Case Management, Managed Care , Discharge Planning and Utilization Management *Case Management training… more
- Novo Nordisk (Orlando, FL)
- …guidelines, chronic care models, protocols, etc. to engage HCPs in clinical conversations to appreciate how they manage patients with diabetes and where they ... Novo Nordisk, we are the world leader in diabetes care and a major player in defeating other serious...Representative also assists their target physicians with their local clinical and educational initiatives by coordinating company resources (eg,… more