- AdventHealth (Altamonte Springs, FL)
- …to nurses, physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge Planning and care ... documents avoidable days, and facilitates progression of care. Collaborates with Utilization Management staff for collaboration on patient status changes and medical… more
- Molina Healthcare (Tampa, FL)
- …Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + Identifies and ... as may be required. + Serves as a clinical resource for Utilization Management, Chief Medical Officer, Physicians, and Member/Provider Inquiries/Appeals. + Provides… more
- ChenMed (Tamarac, FL)
- …Facilitate patient/family conferences to review treatment goals, optimize resource utilization , provide family education and identify needs. Readmission Rate Advance ... directives/End of Life Planning Patient Satisfaction Utilization /Financial Management-managing resource utilization and reimbursement for services. (5% year 1&… more
- Select Medical (Gainesville, FL)
- …professional growth of the department, including, but not limited to: Utilization Review (UR) and resource management, discharge planning, treatment plan management ... patient-specific, safe and timely discharge plan. + Performing verification of utilization criteria reviews. + Building relationships and coordinating with payor… more
- Ascension Health (Jacksonville, FL)
- …recent work experience in a hospital setting, preferably with some Physician Advisory/ Utilization Management work experience. If you are ready to join a talented ... Provide education to physicians and other clinicians on regulatory requirements, appropriate utilization of alternate levels of care, community resources and end of… more
- Abbott (Miami, FL)
- …includes influencing stakeholders within the hospital, driving product utilization , support on contracting, relationship development, relationship management, market ... training. + Influence stakeholders within the hospital setting. + Drive product utilization in key growth categories and driving sales/placement of capital to… more
- Actalent (Orlando, FL)
- …the successful completion of cases. Essential Skills + Experience in utilization management, concurrent review, prior authorization, utilization review, case ... + Active Compact RN License, Compact LPN is okay too + Utilization Management/Concurrent Review experience. + ICU/ER experience. + Strong communication skills. +… more
- Select Medical (Pensacola, FL)
- …by doing what is right. The Case Manager is responsible for utilization reviews and resource management, discharge planning, treatment plan management and financial ... patient specific, safe and timely discharge plan. + Performs verification of utilization criteria reviews. + Builds relationships and coordinate with payor sources… more
- HCA Healthcare (Fort Lauderdale, FL)
- …centralized case management function, including Clinical Case Management, Utilization Review Services, and Clinical Documentation Improvement. Works collaboratively ... policies, practices, efficiencies; and effectiveness of clinical Case Management, Utilization Management, and Social Work functions within the enterprise. +… more
- Adecco US, Inc. (Altamonte Springs, FL)
- …understanding of the cost consequences resulting from Care Management decisions through utilization of reports and systems such as Health Plan Benefits, ... utilization of metrics and CM reports. **Qualifications for the...clinical care setting or equivalent. . Previous care management, utilization review or discharge planning experience. . RN License… more