- HCA Healthcare (Gainesville, FL)
- …more years of home health, public nursing or acute hospital nursing experience + Familiar with Medicare home health regulations, documentation requirements, ... clinical excellence behind the scenes in data science, case management or transfer centers. Unlock your potential at HCA...at Home! **Job Summary and Qualifications** Provides coordinated skilled nursing care to patients of all age groups, in… more
- Humana (Miramar, FL)
- …they need, when they need it. These efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service ... Home Health Wound Ostomy Care RN is a specialized nursing position primarily focused on assessing documentation from field...Educate home health clinicians and physicians on proper wound management techniques. - Focus on care for patients with… more
- Humana (Tallahassee, FL)
- …they need, when they need it. These efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service ... company with a legacy of innovation, evolving from skilled nursing and hospitals to one of the largest health...of this evolution is Humana's Insurance Segment, which provides Medicare Advantage, Medicaid, and other health plans to millions.… more
- Molina Healthcare (FL)
- …Degree in Nursing **Preferred Experience** + 3-5 years in case management , disease management , managed care or medical or behavioral health settings. ... licensed RN to join Molina to work with our Medicare members in the San Antonio service delivery area;...to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based… more
- CenterWell (Clearwater, FL)
- …an accredited School of Nursing . + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's license, auto insurance and reliable ... personnel. This role is a focused on both home health clinical quality assurance and home health clinical operations initiatives. + Develops, plans, implements,… more
- HCA Healthcare (The Villages, FL)
- …work to deliver clinical excellence behind the scenes in data science, case management or transfer centers. Unlock your potential at HCA Florida Healthcare at Home! ... you will need:** + Two years of experience within a licensed and certified ( Medicare ) home health agency required + Competent in Federal ( Medicare ) and Local… more
- Zelis (St. Petersburg, FL)
- …DRG, IBR, and CCR claims. This is a production-based role with production and quality metric goals. What you'll do: + Review provider disputes for DRG Coding and ... timeframe to ensure client turnaround times are met. + Accountable for daily management of claim dispute volume, adhering to client turnaround time, and department… more
- Molina Healthcare (FL)
- …Experience with data reporting, analysis, and/or interpretation + Certified Professional in Health Quality (CPHQ) + Nursing License (RN may be preferred for ... & Community Interventions oversees and implements new and existing clinical quality member intervention initiatives including all lines of business ( Medicare… more
- CVS Health (Tallahassee, FL)
- …* Work collaboratively with the Behavioral Health, Pharmacy, Member Outreach, Care Management , National Quality Management , Utilization Management , ... for DSNP/MMP and other complex health populations to optimize risk adjustment, clinical quality , and care management . * Actively participate in meetings and… more
- AdventHealth (Orlando, FL)
- …Congenital Cardiology Program. The applicant should have expertise in the management of adult congenital heart disease with prominent clinical, teaching, program ... research skills. Excellent skills in leadership, collaboration and clinical management of ACHD patients is a must. The ACHD...team will include but not limited to a registered nurse , Advanced Practice Provider (APRN/PA), and a MA. The… more