- Molina Healthcare (Miami, FL)
- …Bachelor's Degree in Nursing preferred . **Required Experience** 1-3 years in case management, disease management, managed care or medical or behavioral ... in Nursing ** Preferred Experience** 3-5 years in case management, disease management, managed care or medical... case management, disease management, managed care or medical or behavioral health settings. Preferred License,… more
- ChenMed (Margate, FL)
- …join our team. The Care Promoter, Specialist Cardiology is an unlicensed medical professional who has received specialized training to perform routine administrative ... clinical duties under direct physician specialist supervision in accordance with state medical practice acts. The Care Promoter, Specialist is an integral member of… more
- Elevance Health (FL)
- ** Medical Director** _Please note that per our policy t_ _his role enables associates to work virtually full-time, with the exception of required in-person training ... employment, unless an accommodation is granted as required by law._ The ** Medical Director** is responsible for the administration of physical and/or behavioral… more
- CVS Health (Tallahassee, FL)
- … Director will provide clinical, coding, and reimbursement expertise as well as directing case management when necessary. The Medical Director will act as a ... This is a remote based (work from home) role. Preferred candidates will have Internal Medicine or Internal Medicine.../ Pediatrics (Med / Peds) Board Certification. In the Medical Director role, you will provide oversight for … more
- Molina Healthcare (Orlando, FL)
- …Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and ... procedures that guide and support the provision of medical staff services. Maintains a working knowledge of applicable national, state and local laws and regulatory… more
- Cleveland Clinic (Vero Beach, FL)
- …the world. Under the supervision of the Director of Nursing or designee, the Medical Emergency Team (MET) Nurse plays a proactive role in identifying and managing ... supporting clinical decision-making and implementing process improvements and training based on case reviews and quality data. **A caregiver in this role works days… more
- Molina Healthcare (FL)
- …Bachelor's Degree in Nursing preferred . **Required Experience** 1-3 years in case management, disease management, managed care or medical or behavioral ... in Nursing ** Preferred Experience** 3-5 years in case management, disease management, managed care or medical... case management, disease management, managed care or medical or behavioral health settings. Preferred License,… more
- Select Medical (Miami, FL)
- … preferred . + Certified Professional in Healthcare Quality (CPHQ) preferred **Additional Data** Select Medical 's Inpatient Rehabilitation Hospitals provide ... **West Gables** **Rehabilitation Hospital** *A joint venture with Select Medical * **Location: Miami, FL** **$10,000 Sign-on Bonus** **Director of Quality… more
- CVS Health (Tallahassee, FL)
- …skills in a collaborative process to implement, coordinate, monitor and evaluate medical review cases. + Applies the appropriate clinical criteria/guideline and plan ... language or policy specifics to render a medical determination to the client. + Applies critical thinking,...feedback, + Actively cross-trains to perform reviews of multiple case types to provide a flexible workforce to meet… more
- Humana (Tallahassee, FL)
- …and experience with national guidelines such as NCD/LCD, MCG(R) or InterQual The Medical Director conducts clinical case reviews of requests received by members ... a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home… more