- Evolent (Tallahassee, FL)
- …on team metrics and accomplishments. **What You Will Be Doing:** Communicates with medical office personnel to obtain pertinent clinical history and information. ... and health plan's required timeframes. * Documents communications with medical office staff and/or MD provider as...Review or Utilization Management Review as an LPN or LVN is required. + Must maintain a courteous and… more
- Valor Health (Stuart, FL)
- …for the US Department of Veterans Affairs. We provide a full range of medical services to veterans through the operations of CBOCs, tailored to meet the specific ... needs of local VA medical centers. Our comprehensive set of services includes primary...training requirements. Compliance + Fulfill compliance requirements of the Office of Inspector General (OIG), Joint Commission (JC), Environment… more
- Evolent (Tallahassee, FL)
- …and write clearly. + Reviews adverse determinations against criteria and medical policies + Creates adverse determination notifications that meet all accreditation, ... + Appropriately identifies and refers quality issues to the Senior Director of Medical Management or Medical Director. + Appropriately identifies potential cases… more
- Elevance Health (Miami, FL)
- …care setting preferred. + Registered Nurse strongly preferred. + RN, LSW, or LPN/ LVN license preferred. + Proficient in Microsoft Office preferred. Please be ... II GBD Special Program** **Location:** This role requires associates to be in- office 3 days per week, fostering collaboration and connectivity, while providing… more
- Centene Corporation (Tallahassee, FL)
- …(NCQA) HEDIS measures. Provides education for HEDIS measures, appropriate medical record documentation and appropriate coding. Assists in resolving deficiencies ... community physician and small provider practices in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance… more
- Sedgwick (Jacksonville, FL)
- …consult providers and employees; to provide case direction; and to ensure medical information substantiates the need for absence from work. **ESSENTIAL FUNCTIONS and ... clinical review of referred claims; documents decision rationale; and completes medical review of all claims to ensure information substantiates disability. +… more
- Cardinal Health (Tallahassee, FL)
- …experience in related field preferred + Previous social work experience is preferred + LVN is preferred + 2-4 years of Case Management experience is preferred + ... B, C, D) + 1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience is preferred...Intermediate to advanced computer skills and proficiency in Microsoft Office including but not limited to Word, Outlook, and… more
- Sunrise Senior Living (Boca Raton, FL)
- …Team Member_** At Sunrise, our Licensed Practical Nurse/Licensed Vocational Nurse (LPN/ LVN ) is responsible for providing direct resident care and supervision of ... solving and decision making skills - Proficiency in computer skills, Microsoft Office (Windows, Outlook, Excel) with the ability to learn new applications **ABOUT… more
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