- AdventHealth (Sebring, FL)
- …responsible for, but not limited to: Coordination of Care, Centers for Medicare & Medicaid Services (CMS) Conditions of Participation, Social Services implementation ... each position may vary based on geographical location. **Category:** Case Management **Organization:** AdventHealth Heartland **Schedule:** Full-time **Shift:** 1 -… more
- Molina Healthcare (Tampa, FL)
- …MCG, InterQual or other medically appropriate clinical guidelines, Medicaid, Medicare , CHIP and Marketplace, applicable State regulatory requirements, including the ... Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management + Certified Professional in… more
- Aveanna Healthcare (Royal Palm Beach, FL)
- …of patient needs, goals, and progress as required. + Attend patient case conferences and participate in in-services as necessary. + Supervise other personnel, ... may changeat any time with or without notice. As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all… more
- Aveanna Healthcare (West Palm Beach, FL)
- …of patient needs, goals, and progress as required. + Attend patient case conferences and participate in in-services as necessary. + Supervise other personnel, ... change at any time with or without notice. As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all… more
- AdventHealth (Daytona Beach, FL)
- …responsible for, but not limited to: Coordination of Care, Centers for Medicare & Medicaid Services (CMS) Conditions of Participation, Social Services implementation ... each position may vary based on geographical location. **Category:** Case Management **Organization:** AdventHealth Daytona Beach **Schedule:** Full-time **Shift:**… more
- Convey Health Solutions (Fort Lauderdale, FL)
- …follow-ups and stakeholder mapping. + Assist in gathering reference materials, case studies and documentation. + Maintain CRM hygiene by logging stakeholder ... Experience with BI or analytics is a plus. + Familiarity with RFP tracking tools, Medicare Advantage landscape or value-based care models is a plus. About Us WHO WE… more
- Aveanna Healthcare (Naples, FL)
- …physical or emotional condition to the patient's physician and to the RN on the case if applicable, on a timely basis. * Records clinical and progress notes at the ... in the state of practice * Valid CPR As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all… more
- Highmark Health (Tallahassee, FL)
- …system entities in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Determine appeal action, prepare ... Is responsible for or works with external resources to create and monitor inpatient case mix reports and the top 25 assigned DRGs/APCs in the facilities to identify… more
- HCA Healthcare (Tamarac, FL)
- …you will do in this role: + You will work collaboratively with RN case managers, acute care nurses, physicians, insurance companies, and other staff members to ... + You will maintain a thorough working knowledge of the rules of Medicare , Medicaid, and private payer regulations and processes. You will possess a thorough… more
- Humana (Tallahassee, FL)
- …+ Identify important clinical and experience problems and build the business case to solve them through application of clinical, analytical, and business expertise. ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more