- MyFlorida (Tallahassee, FL)
- …Health Nursing Director. Case Management Provide in-person and remote case management for students' medical management plans, ensuring physicians' orders ... (LCHD), the school, the student, the parent/guardian, and the medical community. The position is supervised by a School...as assigned, to complete tasks. Obtain care in the case of homelessness. Make referrals for appropriate care to… more
- Humana (Tallahassee, FL)
- …our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. The ... Behavioral Health Medical Director work assignments involve moderately complex to complex...participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or post-acute… more
- Humana (Tallahassee, FL)
- …a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements, and… more
- Highmark Health (Tallahassee, FL)
- …current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and ... of the requested treatment of service. Depending on the nature of the case , telephonic peer to peer discussions may be required. The incumbent ensures compliance… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... situations or data requires an in-depth evaluation of variable factors. The Medical Director provides medical interpretation and decisions about the… more
- Elevance Health (Miami, FL)
- ** Medical Management Nurse** **Location:** Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training ... 7am - 6pm EST and will include weekends. The ** Medical Management Nurse** will be responsible for review of...skills and nursing judgment and experience. + Collaborates with case management nurses on discharge planning, ensuring patient has… more
- ICW Group (Orlando, FL)
- …support from dedicated in-house counsel for litigation strategy and nurse case managers for medical management. **ESSENTIAL DUTIES AND RESPONSIBILITIES** ... to accelerate closure of high-cost, long-duration claims. + Collaborates with legal, medical , and financial experts to evaluate exposure and resolution pathways. +… more
- Elevance Health (Tampa, FL)
- ** Medical Management Specialist I** **Location** : **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... is granted as required by law. **Shift:** Monday-Friday 8a-5p EST The ** Medical Management Specialist I** is responsible for providing non-clinical support to the… more
- J&J Family of Companies (Orlando, FL)
- …a targeted sales message based on accurate clinical information, using approved medical reprints to support the case , and discussing therapeutic strategies. ... the assigned customer segment, which may include physicians within specialty medical practices and their staff, specialists within local hospitals, clinics, and… more
- Inpatient Psych Solutions (Ocala, FL)
- …adjustment disorders, depression, anxiety, trauma, and other behavioral health challenges in medical settings + Collaborate with physicians, case managers, and ... role offers the opportunity to work directly with patients in acute medical settings, supporting trauma, neurology, general medicine, and rehabilitation units. You… more