- AdventHealth (Tampa, FL)
- …Required. . Certified Provider Credentialing Specialist (CPCS) Required or Certified Professional Medical Staff Management (CPMSM) Required or Ability to obtain ... compliance with NCQA credentialing standards and CMS. Works with AdventHealth Medical Group (AHMG), AdventHealth leadership, Managed Care Organizations and other… more
- Adecco US, Inc. (Jacksonville, FL)
- …and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application ... + Coordinates vendor referrals for additional investigation and/or litigation management . + Uses appropriate cost containment techniques including strategic vendor… more
- Deloitte (Jacksonville, FL)
- …prepare results to share with clients + Create models to calculate ROI for medical management and other health plan initiatives + Prepare IBNR modeling ... complex problems and have a business orientation. Other responsibilities include: + Individual medical and small group health care reform modeling for health plans +… more
- Elevance Health (Tampa, FL)
- …competitive advantage. + Align contracting strategy with internal/external accounts, access, and medical management strategy. + Delivers competitive cost of care ... offers superior clinical mental health and substance use disorder management , a comprehensive employee assistance program, work/life support, specialty programs… more
- HCA Healthcare (Orange Park, FL)
- …and successful progression for the patient from preadmission, through the medical management and/or surgery process, inpatient stay, post-operative/discharge ... root cause analysis, and completion of diagnoses working with medical coders to include CPT and DRG / ICD...Registered Nurse Diploma + APRN preferred + 3 years Medical /Surgical Nursing required + 1 year in Quality Improvement… more
- HCA Healthcare (Lehigh, FL)
- …location, and duration using standardized clinical measures. + Provide outpatient medical management of neuromuscular disorders, musculoskeletal trauma, acute ... offering competitive compensation and benefits package + 401K + Medical /Dental benefits **Job Responsibilities:** + Document examination results, treatment plans,… more
- Centene Corporation (Tallahassee, FL)
- …everything for our 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization ... behavioral analytics (ABA). Additional Details: * Department: Behavioral Health Utilization Management * Business Unit: Corporate / Florida * Schedule: Monday-Friday… more
- Centene Corporation (Tallahassee, FL)
- …everything for our 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization ... to provide education on best practice models and utilization management processes + Interact with the Medical ...utilization management processes + Interact with the Medical Director, or designee, to discuss clinical authorization questions… more
- Centene Corporation (Tallahassee, FL)
- …everything for our 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization ... reviews related to mental health and substance abuse to determine medical appropriateness in accordance with regulatory guidelines and criteria + Performs… more
- VCA Animal Hospitals (Coconut Creek, FL)
- …work environment and maintain our strong hospital culture + Work cohesively with hospital management and medical teams to aid in the progression of the hospital ... firsthand experience + Mentoring technicians within the department + Medical supplies ordering and inventory management +...department + Medical supplies ordering and inventory management + Controlled substances management + … more