- AdventHealth (Deland, FL)
- …with current car insurance **Preferred qualifications:** . Recent, relevant experience in a Medicare -certified home health agency as a case -manager . Certified ... Case Manager . Certificate for OASIS Specialist - Clinical This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay… more
- Molina Healthcare (Miami, FL)
- …more years in one or more of the following areas: utilization management, case management, care transition and/or disease management. + Minimum 2 years of healthcare ... years supervisory/management experience in a managed healthcare environment. + Medicaid/ Medicare Population experience with increasing responsibility. + 3+ years of… more
- Actalent (Sunrise, FL)
- …management + InterQual + Milliman Commercial Guidelines + Medicaid + Medical management + Medicare + Managed care + Patient care + Medical record + Case ... and experience. + Valid Florida Driver's License. + Knowledge of case management and utilization review concepts, including InterQual and Milliman Criteria.… more
- BayCare Health System (Largo, FL)
- …paperwork issues. + One UR will be responsible for a minimum of 100 Medicare Admissions per month. **Position details:** + **Location:** Hybrid - Largo, FL + ... and Licensures:** + Required RN License - Florida + Preferred Case Management Certification **Education:** + Required associate's degree in nursing or… more
- BrightSpring Health Services (Sarasota, FL)
- …ensure that all federal and state law requirements and conditions of participation for Medicare and Medicaid are met. + Gather data for assigned area(s) and prepare ... relationships and be the primary area contact person for case management and contract monitoring personnel assigned to the...Dept. of Health. Attend and participate in area meetings, case staffing, and address local contract concerns as needed.… more
- Molina Healthcare (St. Petersburg, FL)
- …and adherence to appropriate guidelines and support staff who have an ongoing member case load for regular outreach and management. + As a Lead RN provide support, ... HCS Department staff workload for adherence to the Policies, Procedures, Guidelines, Medicare Model of Care, and deadlines. Assures oversight and direction of… more
- HCA Healthcare (Fort Pierce, 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
- HCA Healthcare (Plantation, 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
- HCA Healthcare (Margate, 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 ... maintain a thorough working knowledge of the rules of Medicare , Medicaid, and private payer regulations and processes. You...need:** + Masters of Social Work (MSW) + Previous case management experience + Acute care social work experience… more
- HCA Healthcare (Fort Walton Beach, FL)
- …The MSW maintains a thorough working knowledge of the rules of Medicare , Medicaid, and private payer regulations and processes, and possesses a thorough ... do in this role: + Works collaboratively with RN case managers, acute care nurses, physicians, insurance companies, and...or psychosocial needs. + Obtains input from the RN case manager to ensure the discharge plan is appropriate… more