- AdventHealth (Port Charlotte, FL)
- …patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the interdisciplinary team ... core competencies of this role. The RN Care Manager facilitates the collaborative management of patient care across the continuum, intervening to remove barriers to… more
- AdventHealth (Orlando, FL)
- …inpatients and 125,000 outpatients each year **The role you'll contribute:** **The Care Management Manager is under the general leadership of the Care Management ... of the departmental daily operations and supervision of team members.** **The Care Management Manager is responsible for, but not limited to: Coordination of Care,… more
- AdventHealth (Daytona Beach, FL)
- …benefiting from the resources and support of a leading faith-based health system . **Position Highlights:** + General ENT practice with **outpatient and inpatient ... oncology available on-site + EPIC EMR with **AI scribe system built-in** + Collegial medical staff with **local physician...Most recommended hospital in the region (NRC) + **4-Star CMS rating** **Why Daytona Beach?** + Miles of soft… more
- AdventHealth (Daytona Beach, FL)
- …physicians in 27 individual service lines. This aligned model and practice management experience provides the opportunity for physicians to focus on the clinical ... state income tax **Hospital Overview** **AdventHealth Daytona Beach** is a high quality, CMS 5 Star rated, Leap frog grade A rated, 367-bed tertiary hospital nestled… more
- Elevance Health (Tampa, FL)
- …+ Extensive spine surgery experience preferred. + Experience with utilization management , especially with CMS guidelines preferred. + **Orthopedic Spine ... Associate Medical Director** **Orthopedic Spine Surgery** **Carelon Medical Benefit Management ** **Schedule: 10:30 AM-7 PM Central** **Virtual:** This role enables… more
- CenterWell (Tallahassee, FL)
- …in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part ... clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work… more
- HCA Healthcare (Ocala, FL)
- …Departments as necessary. + Reviews Regulatory and Compliance Communications, applicable CMS transmittals, and Local Coverage Decisions (LCD). Assess impact to ... charging validation reviews preferred. **Parallon** provides full-service revenue cycle management , or total patient account resolution, for HCA Healthcare. Our… more
- HCA Healthcare (Ocala, FL)
- …daily ancillary charge report to identify any potential charging issue related to system failures, system updates or other. Reviews denial trends for ... drive total charge variations. + Reviews Regulatory and Compliance Communications, applicable CMS transmittals, and Local Coverage Decisions (LCD). + Works on Charge… more
- Molina Healthcare (FL)
- …contracted provider network. They are responsible for network management including provider education, communication, satisfaction, issue intake, access/availability ... staff to determine; for example, non-compliance with Molina policies/procedures or CMS guidelines/regulations, or to assess the non-clinical quality of customer… more
- Humana (Tallahassee, FL)
- …inventory monitoring and assignment of escalated inventory + Research on guidelines - CMS , AMA, etc. + Training new coders/auditors + Responsible for updating and ... maintaining processes/resources/guidelines in OneNote & Mentor + Point of contact for coders/auditors + Assist coders with coding or technical issues + Team Engagement + Assist with assignments as appropriate per leader direction **Use your skills to make an… more