- CVS Health (Orlando, FL)
- …issues. . Handles reviews of prior claims to address potential impact on current case management and eligibility. . Creates a holistic approach to assess the ... to clinical resources and to assist in determining functionality. . Ensures case management processes follow organization and regulatory requirements. .… more
- Molina Healthcare (Miami, FL)
- …and law enforcement. + Documents appropriately all case related information in the case management system in an accurate manner, including storage of case ... various internal customers (eg, Provider Services, Contracting and Credentialing, Healthcare Services, Member Services, Claims) to gather documentation pertinent to… more
- CVS Health (Tallahassee, FL)
- …company expense reimbursement policy **Preferred Qualifications:** . Behavioral Health Experience . Case management in an integrated model . Experience providing ... professionals to influence appropriate member care. . Attends and participates in case rounds, including utilization management rounds for behavioral health and… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- …a related field + Background in advocacy, counseling, nursing, or social work + Case management experience in the specific therapy area + Bilingual skills, ... **Job Description** The Patient Nurse Case Manager (PNCM) is a dynamic, field-based role...patient disease-state and education, injection training support, and access management to provide comprehensive support throughout the patient journey.… more
- Elevance Health (Lakeland, FL)
- …Capabilities and Experiences:** + Bilingual in Spanish strongly preferred. + Previous case management or oncology experience strongly preferred. + Experience ... This is a field based position, candidate would need travel in and around the following counties based on...of an RN, with overall responsibility for the member's case , as required by applicable state law and contract,… more
- UNUM (Tallahassee, FL)
- …+ Demonstrate a "can-do" spirit, a sense of optimism, ownership and commitment + Ability to travel + Preference for certification as LG Case GR, LG case VB ... strong producer relationships through superior product and services knowledge, territory management practices, and excellent customer service. + Achieve office and… more
- Molina Healthcare (Orlando, FL)
- …**KNOWLEDGE/SKILLS/ABILITIES** + Provides telephone, clerical, and data entry support for the Case Management team. + Responsible for initial review of assigned ... **JOB DESCRIPTION** **Job Summary** Molina Healthcare Services (HCS) works with members, providers and... case levels to assist in Case Management assignment. + Reviews data to… more
- US Tech Solutions (Hialeah, FL)
- …critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes for members ... **Position Summary:** + Provide comprehensive healthcare management services to facilitate appropriate...decision making at most appropriate level **Duties:** + Coordinates case management activities for Medicaid Long Term… more
- Molina Healthcare (Miami, FL)
- …assessments of members per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or ... **JOB DESCRIPTION** **Job Summary** Molina Healthcare Services (HCS) works with members, providers and...identified in the assessment. + Develops and implements a case management plan in collaboration with the… more
- Molina Healthcare (FL)
- …comprehensive waiver enrollment and disenrollment processes. + Develops and implements a case management plan, including a waiver service plan, in collaboration ... Outlook, Excel, Teams, and One Note. **Job Summary** Molina Healthcare Services (HCS) works with members, providers and multidisciplinary...Long Term Services & Supports. + 1-3 years in case management , disease management , managed… more