- Veterans Affairs, Veterans Health Administration (Miami, FL)
- …are determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. VA ... goals for eligibility, referral and authorization, care coordination, and utilization management to ensure improved Veteran experience. Makes recommendations for… more
- HCA Healthcare (Fort Lauderdale, FL)
- …+ Lead centralized case management function, including Clinical Case Management, Utilization Review Services, and Clinical Documentation Improvement. Works ... + Lead centralized case management function, including Clinical Case Management, Utilization Review Services, and Clinical Documentation Improvement. + Develop,… more
- Matrix Providers (Jacksonville, FL)
- …provider-to-patient ratios and fair, reliable schedules. Matrix Providers is hiring a Licensed Practical Nurse/ Licensed Vocational Nurse - Pain Management to ... the following: + Degree: Be a graduate from a Licensed Practical Nurse (LPN) or Licensed Vocational...coordinating with the local Medical Home Port (MHP) clinic, utilization and Referral Management policies, and obtains additional clinical… more
- HCA Healthcare (Orange Park, FL)
- …representatives, and other parties as appropriate regarding behavioral services . Performs utilization review as assigned . Participates in developing department ... encourage you to apply for our Mental Health Professional Licensed LCSW opening. We promptly review all...Health Professional Licensed LCSW opening. We promptly review all applications. Highly qualified candidates will be contacted… more
- Molina Healthcare (Tampa, FL)
- …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... are seeking a (RN) Registered Nurse who must be licensed for the state they reside This position will...the state they reside This position will support Medical Review for Medicare and Marketplace request authorization. Strongly prefer… more
- HCA Healthcare (Fort Pierce, FL)
- …guidelines. Participates in developing department goals and clinical programming. + Performs utilization review as assigned. + Helps with Process and Quality ... Experience in mental health or related field, required + Licensed Clinical Social Worker (LCSW), or Licensed ...+ Licensed Clinical Social Worker (LCSW), or Licensed Professional Counselor (LPC), or Licensed Marriage… more
- CVS Health (Tallahassee, FL)
- …inpatient, skilled nursing, or rehabilitative stay. Under the direction of a Registered/ Licensed RN, the TOC Coach ensures the member experiences a seamless ... who cannot advocate for themselves. The TOC team will review prior claims to address potential impact on current...community. - Utilizes weekly and daily reporting to identify utilization for the purpose of reducing Emergency Department … more
- CVS Health (Tallahassee, FL)
- …outcomes. * Leverage extensive knowledge of health care delivery system, utilization management, reimbursement methods and treatment protocols for DSNP/MMP and other ... Health, Pharmacy, Member Outreach, Care Management, National Quality Management, Utilization Management, Compliance, and other departments to integrate social,… more
- ChenMed (Tamarac, FL)
- …and explain primary care provider role. Facilitate patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... team. ESSENTIAL JOB FUNCTIONS: The Primary Care Physician (PCP) is a licensed /Board Certified/Board Eligible trained professional in internal or family medicine who… more
- Colliers Engineering & Design (Tampa, FL)
- …a client's satisfaction and firm's expectations in terms of resource utilization and profitability. Actively manages client budgets, schedules, programs, project ... firm resources. + Oversees the production of design and construction documents, review of constructability issues, and provides solutions to design problems and… more