- CenterWell (Jacksonville, FL)
- …leading clinical performance in patient experience, quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts ... precise + Identify critical issues for high-risk patients during case reviews & other forums, and modeling and driving...(HRPM), and social determinants of health (SDOH) efforts, improving clinical outcomes and avoidable utilization + Monitor… more
- CenterWell (Daytona Beach, FL)
- …leading clinical performance in patient experience, quality of care, clinical outcomes, and avoidable utilization *Periodically review clinician charts to ... patient management (HRPM), and social determinants of health (SDOH) efforts, improving clinical outcomes and avoidable utilization *Monitor and manage daily… more
- AdventHealth (Winter Haven, FL)
- …+ Recent, relevant experience in a Medicare-certified home health agency as a case - manager + Certificate for OASIS Specialist - Clinical + Home Health ... Physical Therapist Care Manager Home Health - AdventHealth Home Health All...to support productivity, efficiency and maintain best practice visit utilization . + Performs an evaluation, assessing function using a… more
- AdventHealth (Orlando, FL)
- …as a case - manager + COS-C - Certificate for OASIS Specialist - Clinical + Home Health Case - Manager Certification This facility is an equal ... Registered Nurse Case Manager - AdventHealth Home Health...to support productivity, efficiency and maintain best practice visit utilization . + Assesses physical, functional, psychosocial, social, spiritual, educational,… more
- Terumo Aortic (Sunrise, FL)
- …planning and execution of promotional and educational activities including speaker programs, case observations, and workshops. + Develops a clinical paper ... strategy in conjunction with Clinical Marketing, Downstream Marketing, and Manager of Medical Education + Actively involved in sales and clinical … 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
- Elevance Health (Tampa, FL)
- …an impact.** Primary duties may include, but are not limited to: + Gathers clinical information regarding case and determines appropriate area to refer or assign ... case ( utilization management, case management,...utilization management review activities which require interpretation of clinical information. **Minimum Requirements:** + Requires a HS diploma… more
- Elevance Health (Tampa, FL)
- …necessity of requests using clinical criteria. + Performs physician-level case review of musculoskeletal utilization requests. + Conducts peer-to-peer ... ** Clinical Operations Associate Medical Director** **Orthopedic Spine Surgery**...+ Extensive spine surgery experience preferred. + Experience with utilization management, especially with CMS guidelines preferred. + **Orthopedic… more
- CVS Health (Tallahassee, FL)
- …applies critical thinking skills in addition with team based decision rubric to assure case is reviewed by a practitioner with clinical expertise for the issue ... Qualifications** - Emergency/critical care experience - Experience working Grievance cases - Case Management or Utilization Management experience - Managed care… more
- AdventHealth (Maitland, FL)
- …CERTIFICATION, OR REGISTRATION PREFERRED:** + Case Management certification - Accredited Case Manager (ACM) + Certified Case Manager (CCM) ... who are at high risk for readmission or for high emergency room utilization . Follows up with patients at location of post discharge transfer. Conducts patient… more