- Molina Healthcare (Miami, FL)
- **Job Summary** **_For this position we are seeking a (RN) Registered Nurse who must be licensed for the state of KENTUCKY or have a compact license._** Provides ... Plan Scorable Action Items (SAIs) to ensure performance and quality levels exist in PI Business products and processes....and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements… more
- Molina Healthcare (Orlando, FL)
- …(QIA) in collaboration with the clinical lead, the medical director, and quality improvement staff. + Facilitates conformance to Medicare , Medicaid, NCQA ... + Monitors appropriate care and services through continuum among hospitals, skilled nursing facilities and home care to ensure quality , cost-efficiency, and… more
- Fresenius Medical Center (Trenton, FL)
- …effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with FMCNA policies procedures and training and in compliance ... a safe and clean working environment. Supports the FMCNA commitment to the Quality Enhancement Program (QEP) and CQI Activities including those related to patient… more
- AdventHealth (Davenport, FL)
- …research, leading-edge technology and an extensive team of medical specialists. . High- quality care that has been recognized by the Joint Commission, the American ... in the central hub of tourism. **The role you'll contribute:** The Care Management Facility Director has full accountability and oversight for the overall operations… more
- Molina Healthcare (St. Petersburg, FL)
- …**Preferred Experience** 3-5 years clinical practice with managed care, hospital nursing , utilization and/or care management experience. **Preferred License, ... to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based...the health plan HCS Department staff. Consults with the Management of HCS to devise and implement corrective action… more
- Aveanna Healthcare (West Palm Beach, FL)
- …staff. + Enhance the clinical expertise of field staff to ensure safe, high- quality nursing care. + Collaborate with the operations and business development ... Details Requisition #: 204569 Location: West Palm Beach, FL 33401 Category: Nursing Salary: $67,000.00 - $70,000.00 per year Position Details Position: Clinical… more
- AdventHealth (Tampa, FL)
- …patient care team regarding documentation guidelines, including physicians, allied health practitioners, nursing , care management and etc The CDS adheres to ... . Qualifications **The expertise and experiences you'll need to succeed:** Bachelor's Registered Nurse (RN) 5 years acute care nursing experience with specific… more
- Molina Healthcare (Miami, FL)
- …supervisory/ management experience in a managed healthcare environment. + Medicaid/ Medicare Population experience with increasing responsibility. + 3+ years of ... in Healthcare Management Certification (CPHM), Certified Professional in Health Care Quality (CPHQ), or other healthcare or management certification. To all… more
- AdventHealth (Altamonte Springs, FL)
- …patient care team regarding documentation guidelines, including physicians, allied health practitioners, nursing , and care management . The CDS adheres to strict ... the Clinical Documentation Integrity Manager, and in collaboration with physicians, nursing and HIM coders, the Clinical Documentation Specialist (CDS) strategically… more
- Humana (Tallahassee, FL)
- …you will be a key enterprise leader, with responsibility for evolving Humana's Utilization Management of medical review by physician or nurse , with a focus on ... facilitate new hires and remediation of medical directors performing Medicare utilization management processes and be the...need it. These efforts are leading to a better quality of life for people with Medicare ,… more