- Healthfirst (FL)
- **This position is 100% Remote **Duties/Responsibilities:** + Provides case management services for assigned member caseloads which includes: + Pre-certification ... Negotiates rates with non-partner providers, where applicable. Ensures appropriate access and utilization of a full continuum of network and community resources to… more
- Molina Healthcare (FL)
- …Practical Nurse in good standing. **Preferred Education** Completion of an accredited Registered Nurse ( RN ) Program or a bachelor's degree in Nursing. ... as well as Molina Healthcare business needs. In addition, the Delegation Oversight Nurse will assist the Delegation Oversight Manager with additional duties of… more
- AdventHealth (Maitland, FL)
- …Bachelors degree in Nursing Degree (or advanced degree) + Experience in Case Management , Utilization Management , Transitional Care + Experience with ... Manager System Educator Lead (CMEL) is a care management professional who supports the Director of System Care...+ Three (3) years functional healthcare setting + If RN , Current and valid Florida or Multi-State Department of… more
- CenterWell (Daytona Beach, FL)
- …the strategic intent + Overseeing other clinicians which includes Physicians, Advanced Registered Nurse Practitioners (ARNP), and Physicians Assistants (PA) + ... + Identifying trends and areas of opportunity in pharmacy utilization (pharmacy management ) to impact Part D...of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing… more
- HCA Healthcare (Fort Walton Beach, FL)
- …Cardiac Life Support must be obtained within 30 days of employment start date + Registered Nurse + ONS Chemo / Biotherapy Fundamentals Provider must be obtained ... a(an) Director MCU with HCA Florida Fort Walton-Destin Hospital, you can be a manager in an organization that is devoted to giving! **Benefits** HCA Florida Fort… more
- ChenMed (Miami, FL)
- …in area of specialty required; Master's degree in Nursing required. + Valid, active Registered Nurse license required + For NPs: Board certification by AANP or ... trends in patient conditions and develops, documents and implements a patient management plan based on interpretation of findings. Aids in the development of… more
- HCA Healthcare (Panama City, FL)
- …to such regulations and quality initiatives as it relates to the provision of Case Management Services. + Collaborates with RN Case Managers in the plan of care ... or other problems; functions as a liaison with insurance/managed care/ utilization review companies and provides documentation of the above...setting and along the healthcare continuum. + Assists the RN Case Manager with updates from insurance… more
- CenterWell (Tallahassee, FL)
- …a part of our caring community and help us put health first** The Compliance Nurse 2 reviews utilization management activities and documentation to ensure ... RN license in the state(s) in which the nurse is required to practice + Ability to be...experience a plus + Previous experience in chronic disease management , utilization management , case … more
- AdventHealth (Deland, FL)
- …The Social Work Specialist is under the general supervision of the Care Management Supervisor or Manager and is responsible for patient evaluations of ... for individuals from at-risk populations from interdisciplinary team members (including physicians, RN Care Managers, staff nurses, and other members of the care… more
- AdventHealth (Orlando, FL)
- …The Clinical Social Worker, Licensed, is under the general supervision of the Care Management Supervisor or Manager and is responsible for patient evaluations of ... - Certified Case Management Preferred or + CCM - Certified Case Manager Preferred This facility is an equal opportunity employer and complies with federal, state… more