- HCA Healthcare (Miami, FL)
- …and continued stay and discharge criteria. Orientation will also include Medicare and insurance benefits, grievance procedures, treatment plan process, and rights ... experience required + Certification in case management or utilization review preferred + InterQual experience preferred HCA Florida Mercy...to apply for our Case Mgr RN opening. We review all applications. Qualified candidates will be contacted by… more
- HCA Healthcare (Panama City, FL)
- …are high. **What you will do in this role:** + Coordinate NCD/LCD/LCA review process at the Division level + Determine whether new/revised NCDs/LCDs/LCAs apply to ... resolution + Monitor compliance with HCA Healthcare Policy REGS.GEN.011, Medicare - National and Local Coverage Determinations + Government/Non-government medical… more
- HCA Healthcare (Fort Pierce, FL)
- …and continued stay and discharge criteria. Orientation will also include Medicare and insurance benefits, grievance procedures, treatment plan process, and rights ... nursing experience required + Certification in case management or utilization review preferred InterQual experience preferred HCA Florida Lawnwood Hospital is a… more
- HCA Healthcare (Aventura, FL)
- …and continued stay and discharge criteria. Orientation will also include Medicare and insurance benefits, grievance procedures, treatment plan process, and rights ... nursing experience required + Certification in case management or utilization review preferred + InterQual experience preferred HCA Florida Aventura Hospital is… more
- CenterWell (Daytona Beach, FL)
- …experience, quality of care, clinical outcomes, and avoidable utilization *Periodically review clinician charts to identify opportunities in care, ensuring clinical ... indicators (KPIs), such patient experience via Net Promoter Score (NPS) and Medicare clinical quality via HEDIS, meeting local and organizational goals *Personally… more
- Aveanna Healthcare (Crystal River, FL)
- …Documents effectively resulting in no technical or clinical denials subsequent to review of documentation by payers + Maintain effective communication between staff, ... Health Therapy and completion of OASIS documentation As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements… more
- Aveanna Healthcare (St. Petersburg, FL)
- …Documents effectively resulting in no technical or clinical denials subsequent to review of documentation by payers + Maintain effective communication between staff, ... drivers license and proof of automobile insurance As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in… more
- Aveanna Healthcare (Naples, FL)
- …Documents effectively resulting in no technical or clinical denials subsequent to review of documentation by payers + Maintain effective communication between staff, ... Health Therapy and completion of OASIS documentation As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements… more
- ChenMed (St. Petersburg, FL)
- …with departmental policies and procedures through conferences, personal inspections and review of report. **ESSENTIAL DUTIES AND RESPONSIBILITIES:** + Reviews and ... quality improvement. + Follows all applicable government regulations including HIPAA, Medicare and Co-pay requirements. + Engages patients by offering assistance,… more
- HCA Healthcare (Kissimmee, FL)
- …+ You will maintain a thorough working knowledge of the rules of Medicare , Medicaid, and private payer regulations and processes. You will possess a thorough ... encourage you to apply for our Social Worker PRN opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. **Unlock… more