- AdventHealth (Orlando, FL)
- …PREFERRED** : + Acute care experience + Experience in Case Management, Managed Care , Discharge Planning and Utilization Management + Case Management training ... The Hospitalist RN partners with the contracted Hospitalist MD/Provider and the Care Management Team to manage escalated issues and complex cases in an… more
- The Walt Disney Company (Lake Buena Vista, FL)
- …environments to assess aquatic animal welfare with implications for species within managed care and wild counterparts. + Co-project management of ongoing, ... team and culture by working on projects optimizing animal care , health and welfare along with guest experience and...systems and cognition in the context of applied animal care and welfare, as you collaborate with stakeholders within… more
- CenterWell (New Smyrna Beach, FL)
- …applications **Preferred Qualification** + Bachelor's Degree in Nursing + 3+ years of managed care experience + 3+ years of case management experienceBilingual; ... many other opportunities. **About Us** About Conviva Senior Primary Care : Conviva Senior Primary Care provides proactive,...Conviva Senior Primary Care : Conviva Senior Primary Care provides proactive, preventive care to seniors,… more
- CVS Health (Tallahassee, FL)
- …of clinical experience required in med surg or specialty area - Managed Care experience preferred, especially Utilization Management **Education** - Associates ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- Molina Healthcare (Tampa, FL)
- …or other related needs. * Participates in the Statewide Advocacy Program for Managed Care including working with the State External Advocate, Enrollment ... to identify trends or problem areas of access and care delivery. Assists enrollees in the grievance process at...providers as needed. * Works in collaboration with the Care Management department to help resolve member issues/concerns, ensure… more
- Centene Corporation (New Port Richey, FL)
- …Bachelor's degree in related field or equivalent experience. Two years of managed care or medical group experience, provider relations, quality improvement, ... relations to ensure delivery of the highest level of care to our members. Engage with providers to align...performance metrics, and identify opportunities for improvement in patient care and clinical practices. + Value-Based Care … more
- Prime Therapeutics (Tallahassee, FL)
- …Registered Nurse (RN). + 5 years of post-degree clinical experience. + Experience in managed care , specialty drugs, care management and utilization review. + ... facility.Discusses financial and clinical considerations with members who are considering care at a higher cost treatment site, researches available financial… more
- Actalent (Sunrise, FL)
- …+ InterQual + Milliman Commercial Guidelines + Medicaid + Medical management + Medicare + Managed care + Patient care + Medical record + Case management ... on utilization review issues. The role involves managing continuity of care , ensuring smooth transitions, patient satisfaction, safety, and appropriate length of… more
- Merck (Tallahassee, FL)
- …of their current practice structure, business model, and key influencers ( Managed Care Organization/payers, employers, state policy), and their patients' ... within their assigned geography. These customers may include health care providers such as physicians, nurses, pharmacists as well...their geography there are a diverse set of health care locations that they will call upon in order… more
- Evolent (Tallahassee, FL)
- …skills + Outstanding written and oral presentation skills + Preferred experience with managed care and/or provider engagement **To comply with HIPAA security ... and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented...we seek to connect the pieces of fragmented health care system and ensure people get the same level… more