- BAYADA Home Health Care (Orlando, FL)
- …for quality and adherence to policies and procedures. As a member of the Medicare Case Management (MCM) office, individuals in this role are expected to ... Manager provides support to all BAYADA Home Health Care Medicare service offices by monitoring Outcome and Assessment Information...the OASIS and ICD 10 coding while using the Medicare PDGM billing model and CMS guidelines. + Review… more
- Humana (Tallahassee, FL)
- …teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to ... includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age). + Current and ongoing Board… more
- Humana (Tallahassee, FL)
- …other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and Medicaid requirements, and will understand how ... includes some experience in an inpatient environment and/or related to care of a Medicare or Medicaid type population + Current and ongoing Board Certification in an… more
- Molina Healthcare (St. Petersburg, FL)
- …and due-date logic * Proven history of building-or running-real-time dashboards that keep case aging within SLA * Demonstrated skill in root-cause triage that routes ... Quality, and Operations to fund high-return enhancements. **Core** ** ** **Duties** 1. Case Audits - Run scheduled and ad-hoc audits across internal and delegated… more
- Molina Healthcare (Orlando, FL)
- …the performance of prior authorization, inpatient concurrent review, discharge planning, case management and interdisciplinary care team activities. + Ensures that ... License without restrictions (free of sanctions from Medicaid or Medicare ) **PREFERRED EDUCATION:** Master's in Business Administration, Public Health, Healthcare… more
- CVS Health (Tallahassee, FL)
- …various life and work situations. + Appropriately documents member interactions and research/ case fulfillment in the system. + Works in an inbound and outbound ... + 1+ year(s) experience in social work, social services, or case management field. + Private, confidential workspace free from distractions.professional,… more
- Molina Healthcare (FL)
- …to AVP, VP and senior management + Consultative role, develops business case methodologies for programs, develops and coordinates implementation of business strategy ... + Collaborates and facilitates activities with other units at corporate and Molina Plans. **JOB QUALIFICATIONS** **Required Education** Bachelor's degree or equivalent combination of education and experience **Required Experience** 7-9 years **Preferred… 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 business ... and clinical liaison to network providers and facilities if needed, to support the effective execution of medical services programs by the clinical teams. **Required Qualifications** *Two (2) or more years of experience in Health Care Delivery System eg,… more
- HCA Healthcare (Kissimmee, FL)
- …Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Case Management Assistant with HCA Florida Osceola Hospital you can be a part ... in our organization. We are looking for an enthusiastic Case Management Assistant to help us reach our goals....including having the Patient Choice letter signed. + Monitors Medicare patient's planned discharge dates and delivers the Important… more
- HCA Healthcare (Fort Walton Beach, FL)
- …and integrity. We care like family! Jump-start your career as a Case Management Assistant today with HCA Florida Fort Walton-Destin Hospital. **Benefits** HCA ... vary by location._** Come join our team as a Case Management Assistant. We care for our community! Just...including having the Patient Choice letter signed. + Monitors Medicare patient's planned discharge dates and delivers the Important… more