- 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
- University of Miami (Miami, FL)
- …evidenced-based research and national standards. + Consults with and serves as a clinical resource for unit management to ensure quality patient ... + Contribute to the preparation of multimedia learning packages + Use multimedia learning resources + Make appropriate use of clinical simulators + Evaluate and… more
- Elevance Health (Tampa, FL)
- … and determines appropriate area to refer or assign case (utilization management , case management , QI, Med Review). + Provides information regarding ... Management Specialist I** is responsible for providing non- clinical support to the Medical Management and/or...clinical information regarding case… more
- Select Medical (Miami, FL)
- …Miami, FL** **$10,000 Sign-on Bonus** **Director of Quality Management ** **(DQM)** **Responsibilities** **Position Summary** Coordinates the Medical Quality ... Management and Performance Improvement activities to measurably enhance the...and compliance of quality processes/activities in the areas of clinical /medical staff PI for all applicable clinical /medical… more
- Medical Mutual of Ohio (Fort Myers, FL)
- …work-life, and coordinates resources . + Coordinates and completes case management of intakes. + Makes clinical determinations in adherence with Company ... individual plans. **Provides telephonic/virtual, and /or face to face counseling, coaching, resource coordination, and case management for Employee… 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 ... health care team, payors, and providers to achieve appropriate resource management to implement safe discharge plan...the appropriate use of software and applications and enters case management information accurately and in a… more
- Wounded Warrior Project (Jacksonville, FL)
- …to families waiting for enrollment. + Actively participate in committee assignments. Resource management and development: + Cultivate and maintain relationships ... of experience working with brain injury, cognitive, neurological, or mental health case management . Preferences + Five years of experience assisting military… more
- CVS Health (Tallahassee, FL)
- …of Stay) to clinical staff Identifies triggers for referral into Aetna's Case Management , Disease Management , Mixed Services, and other Specialty ... resolution of claims payment issues -Supports the administration of the hospital care, case management and quality management processes in compliance with… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …environment. + Minimum 2 years of experience with pre-authorization, utilization review/ management , case management , care coordination, and/or discharge ... service requests. + Reviews cases referred by the prior-authorization non- clinical medical management coordinator and pre-certification technician staff… more
- MyFlorida (Orlando, FL)
- …health services agency in lieu of an Associate's degree. + Completion of Medical Case Management AETC Southeast AIDS Education course within 30 days of hire. ... visits. + Current HIV 500/501 certification. + Current Medical Case Management AETC Southeast AIDS Education certification....with a wide range of public & private community resources . + Ability to explain resource options… more