- Elevance Health (Miami, FL)
- …require nursing judgment, critical thinking, and holistic assessment of member's clinical presentation to determine whether to approve requested service(s) as ... Works with healthcare providers to understand and assess a member's clinical picture. Utilizes nursing judgment to determine whether treatment is medically… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …information. Preferred: + Bachelor's or master's degree in nursing (BSN/MSN) + Certified Case Manager (CCM) or similar certification + Fluent in Spanish ... and community resources. + Authorize services and coordinate referrals based on clinical guidelines and insurance coverage. + Provide telephonic and/or in-person … more
- Elevance Health (Tampa, FL)
- …and providers. **How you will make an impact:** + Ensures timely completion of clinical case reviews for their board certified specialty. + Makes physician to ... profession. + Minimum of 1 year of experience with clinical case reviews for medical necessity. _The...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Terumo Aortic (Sunrise, FL)
- …planning and execution of promotional and educational activities including speaker programs, case observations, and workshops. + Develops a clinical paper ... Thoracic devices, namely Thoraflex, to include in-servicing and initial case support. + Maintains a network of case...conjunction with Clinical Marketing, Downstream Marketing, and Manager of Medical Education + Actively involved in sales… more
- Prime Therapeutics (Tallahassee, FL)
- …for drug infusion services versus the hospital outpatient facility.Discusses financial and clinical considerations with members who are considering care at a higher ... for drug services. + Will actively maintain a required case load and the activities to reach overall goals...these cases in web-based application and spreadsheets. + Supports clinical services such as the appeals program. + Participates… more
- Communities Connected for Kids (Port Saint Lucie, FL)
- …crisis calls, regarding placement issues + Assist the Protective Investigator or the Case Manager in developing the initial plan of placement action and ... Care Support, SAMH, etc., when indicated. + Assist the Protective Investigator and Case Manager with the placement of children into foster homes, and acute care… more
- AdventHealth (Orlando, FL)
- …Cardiac Life Support) certification **LICENSURE, CERTIFICATION, OR REGISTRATION PREFERRED:** + Case Management certification Accredited Case Manager (ACM) ... patient from achieving increased stability in daily living. + Prioritizes clinical problems, formulates treatment goals, and constructs treatment plan, revising as… more
- AdventHealth (Palm Coast, FL)
- …home health agency as a case - manager . Certified Case Manager . Certificate for OASIS Specialist - Clinical This facility is an equal opportunity ... **Home Health Occupational Therapy Care Manager - AdventHealth Home Health** **All the benefits...and cognitive factors, documenting the measurement results in the clinical record. Sets priorities of home care caseload adapting… more
- Immigration and Customs Enforcement (Miami, FL)
- …with all applicable policies, accreditation standards, laws, and regulations. Collaborates with the Clinical Director and Nurse Manager , as a function of the ... local leadership team (TRIAD) working in collaboration with the clinical director and nurse manager . This is...health care, and public health services. IHSC provides medical case management and oversight for an additional 22,600 detainees… more
- Elevance Health (FL)
- …office visits with providers and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering ... programs to improve quality, cost, and outcomes. May provide clinical consultation and serve as clinical /strategic advisor...manager . + May be responsible for an entire clinical program and/or independently performs clinical reviews.… more