- CenterWell (Belle Glade, FL)
- …include prior care or case management work with transitions of care and high- risk patient management programs in partnership with PCP care team members including ... + Initiate care planning and subsequent action steps for high- risk members, coordinating with interdisciplinary team + Supporting patients' self-determination,… more
- Elevance Health (FL)
- …+ Medical Cost Management (claims review, payment integrity, utilization management, risk adjustment). + Cost of Care Optimization (clinical analytics, care ... oversee technology partnerships relevant to cost-of-care capabilities. + Ensure compliance with healthcare regulations (HIPAA, CMS, state-specific requirements). **Position… more
- Elevance Health (Tampa, FL)
- …physician and hospital medical records to ensure proper ICD-9 coding and compliance with risk adjustment requirements. **Location:** Virtual: This role enables ... project and RADV. + Assists with National and Targeted Risk Adjustment Data Validation audits. + Participates and represents...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Jacobs (The Villages, FL)
- … Manager (CCM) * Project Management Professional (PMP) * Risk Management Professional (RMP Jacobs is an Equal Opportunity/Affirmative Action Employer. ... path analysis, project budget analysis, project earn value measurement tracking, risk management, proposals, cashflow and reporting tools. You will assist with… more
- ChenMed (Pembroke Pines, FL)
- …within the market. + Consults with the Medical Director, Cardiology to ensure compliance with guidelines along with participating in risk and quality management ... + Performs other related duties as assigned and modified at manager 's discretion. **KNOWLEDGE, SKILLS AND ABILITIES:** + Thorough knowledge of pharmacological… more
- Northrop Grumman (Melbourne, FL)
- …liaison for the project leadership and manage all scheduling, change management, risk management, and cost management requirements for the assigned projects, while ... manage schedules and prepare status reports; and ensure project remediation and ongoing compliance goals are met + Assist in assessing, documenting, and tracking of… more
- Northrop Grumman (Melbourne, FL)
- …Control Account Manager (CAM) experience or training + Experience in Risk Mitigation + Experience in Change Management + In-Scope DOD Secret Security Clearance ... strategies and opportunities to reduce cost, improve efficiency and manage risk through strategic and targeted negotiations. Manages performance of subcontracts,… more
- University of Miami (Medley, FL)
- …Review Specialist (H) under the general direction of the Inpatient Coding Manager works closely with the University of Miami Health's Clinical Documentation ... coding opportunities supported by documentation, enhancing severity of illness and risk of mortality indicators through the provider query process. + Validates… more
- Zurich NA (Tallahassee, FL)
- …Underwriter OR AVP, Underwriting Director- Contract Surety officer level. The hiring manager will determine the appropriate level based upon the selected applicant's ... location, role, skill set, and level of experience. In compliance with local laws, Zurich commits to providing a...North America has over 150 years of experience managing risk and supporting resilience. Today, Zurich North America is… more
- AdventHealth (Orlando, FL)
- …APRN/PA is responsible for coordinating and managing the patient care of high- risk patient populations throughout the continuum to optimize the patient's clinical, ... patients evaluation. This includes communicating as necessary with insurer case manager * Developing and instituting candidates plan of care * Obtaining… more