- CenterWell (Tallahassee, FL)
- …and staff, working collaboratively with the market's Stars Clinical Quality RN /s, to support staffed clinical and operations teams including center administrators. ... implementing quality improvement best practice initiatives designed to improve Medicare quality measures (HEDIS), patient safety and patient experience (CAHPS-HOS).… more
- Molina Healthcare (FL)
- …quality member intervention initiatives including all lines of business ( Medicare , Marketplace, Medicaid). Executes health plan's member and community quality ... skills. **PREFERRED QUALIFICATIONS:** + 1 year of experience in Medicare and in Medicaid managed care + Experience with...Certified Professional in Health Quality (CPHQ) + Nursing License ( RN may be preferred for specific roles) + Certified… more
- HCA Healthcare (Port Charlotte, FL)
- …What 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...to give people a healthier tomorrow."- Jane Englebright, PhD, RN CENP, FAAN Senior Vice President and Chief Nursing… more
- Aveanna Healthcare (Clermont, FL)
- …each visit o Observe and report significant changes in patient's condition to the ( RN ) Nursing Supervisor Requirements * High school graduate or GED * Current BLS ... required by state * Georgia: o Successful completion of Nurse Aide training and competency evaluation program pursuant to...time with or without notice. As an employer accepting Medicare and Medicaid funds, employees must comply with all… more
- CenterWell (Lake Mary, FL)
- …directed. **Use your skills to make an impact** **Required Experience/Skills:** + RN /LPN/LVN license. + Must have strong knowledge of governmental regulations, ... Medicare eligibility requirements, comprehensive understanding of potential care plan needs for the patient and coordination of necessary resources. + Excellent… more
- HCA Healthcare (Tallahassee, FL)
- …What 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 (Belle Glade, FL)
- …of our caring community and help us put health first** The Licensed Practical Nurse is responsible and accountable for making decisions that are based on the ... as ordered on patient plan of care. Report's problems/potential problems to RN /Case Manager.forward and of moderate complexity. The Licensed Practical Nurse … more
- BayCare Health System (Sarasota, FL)
- …insurance, and benefit information. + Verifying insurance and benefits for all Medicare , Managed Care and Private Fee for Service Plans. Securing authorization for ... Assistant will work under the direction of the Care Transition Coordinator or RN Case Manager to establish and maintain a positive working relationship with… more
- HCA Healthcare (Kissimmee, FL)
- …**What you will do in this role:** + You will work collaboratively with RN case managers, acute care nurses, physicians, insurance companies, and other staff members ... + 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
- Actalent (Sunrise, FL)
- Utilization Management Nurse !Job Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing service authorization requests to ensure ... Milliman Commercial Guidelines + Medicaid + Medical management + Medicare + Managed care + Patient care + Medical...record Additional Skills & Qualifications + Current unrestricted Florida RN or LPN License. + Minimum of one year… more