- Datavant (Tallahassee, FL)
- …of service. This is a leadership role that combines strategic thinking, clinical product development expertise, and people management responsibilities. You'll be ... grow. **Key Qualifications** **Required** + 8+ years of product management experience in healthcare, including ownership of clinical...reviewed by Datavant Human Resources and determined on a case -by- case basis. Depending on the state in… more
- Sedgwick (Tallahassee, FL)
- …equivalent combination of education and experience required to include five (5) years medical case management , two (2) years clinical experience, two (2) ... client satisfaction; to ensure efficient, cost effective, and high quality delivery of case management and utilization review services to clients for multiple… more
- Humana (Tallahassee, FL)
- …prior experience participating in teams focusing on quality management , utilization management , case management , discharge planning and/or home health or ... + Experience working with Case managers or Care managers on complex case management , including familiarity with social determinants of health. + The… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- Responsibilities: + Point of contact for providers regarding medical/behavioral/ clinical services or benefits. Including (e-g notification, authorization). + Extract ... and review fax requests for medical or clinical services requests. + Receive calls requesting medical/...steps. + Take calls and questions from providers regarding case status and provide/explain authorization information to providers. +… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …clinical guidelines and insurance coverage. + Provide telephonic and/or in-person case management and member education regarding conditions, medications, and ... process. + Responsible for the appropriate use of software and applications and enters case management information accurately and in a timely manner. + Adheres… more
- Florida Health Care Plans, Inc. (Daytona Beach, FL)
- …and maintain collaborative working relationships with FHCP colleagues and external vendors in providing case management services is essential to the role. ... the community to various locations. POSITION SUMMARY: As part of the Utilization Management division, the social worker will intervene with members who have complex… more
- Humana (Tallahassee, FL)
- …prior experience participating in teams focusing on quality management , utilization management , case management , discharge planning and/or home health or ... + Experience working with Case managers or Care managers on complex case management , including familiarity with social determinants of health + The curiosity… more
- ChenMed (North Miami, FL)
- …continuity of care and cost effectiveness through the integrating and functions of case management , utilization review and discharge planning. The incumbent in ... **ESSENTIAL JOB DUTIES/RESPONSIBILITIES:** + Coordinates the integration of social services/ case management functions into the patient care, discharge… more
- ThermoFisher Scientific (Alachua, FL)
- …as a deep understanding of clinical -trial operations (recruitment, start-up, clinical operations, data management , RBM, safety) and associated regulations. ... impactful software features that exceed customer expectations. + Deep understanding of clinical trial processes, clinical data management , and leveraging… more
- AdventHealth (Altamonte Springs, FL)
- …each position may vary based on geographical location. **Category:** Case Management **Organization:** AdventHealth Corporate **Schedule:** Full-time **Shift:** ... Utilization Management , the Physician Advisor is responsible for providing clinical review of utilization, claims management , and quality assurance related… more