- Highmark Health (Tallahassee, FL)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. ... industry, corporate, state, and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create care plans… more
- Molina Healthcare (Jacksonville, FL)
- …Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of ... oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical… more
- Elevance Health (Miami, FL)
- …and providers. **How you will make an impact:** + Perform physician-level case review, following initial nurse review, of Medical Oncology regimens and supportive ... care. + Perform physician-level case review, following initial nurse review, of chemotherapy regimens....and other staff in understanding the principles behind appropriate utilization of covered treatments and genetic testing. + Participate… more
- AdventHealth (Maitland, FL)
- …Cardiac Life Support) certification **LICENSURE, CERTIFICATION, OR REGISTRATION PREFERRED:** + Case Management certification Accredited Case Manager (ACM) ... high risk for readmission or for high emergency room utilization . Follows up with patients at location of post...record after each significant contact and at closure of case . + Evaluates practice upon completion of case… more
- AdventHealth (Maitland, FL)
- …Care Management setting (Preferred) + Licensed Clinical Social Work (LCSW) (Preferred) + Accredited Case Manager , Certified Case Manager , or Board ... Altamonte Spgs Fl **The role you'll contribute:** The Care Manager System Educator Lead (CMEL) is a care management...in Nursing Degree (or advanced degree) + Experience in Case Management, Utilization Management, Transitional Care +… more
- AdventHealth (New Smyrna Beach, FL)
- …and residency programs. The CMO serves as physician advisor to the Case Management staff, clinical documentation integrity, and serves as physician liaison to ... promote appropriate utilization of resources by the medical staff. Performance improvement...members and lower cost. Direct reports include Med Staff Manager + Clinical Effectiveness including performance improvement, infection control… more
- ChenMed (St. Petersburg, FL)
- …The incumbent in this role is responsible for providing psychosocial assessment, social case work and linkage to community resources for patients who have chronic, ... wellness tools and resources for the care team's awareness and utilization with patients in need. **Communication:** + Maintains communication with interdisciplinary… more
- AdventHealth (Deland, FL)
- **RN Case Manager | AdventHealth Home Health** **All the benefits and perks you need for you and your family:** Up to $5,000 Sign on Bonus Benefits from Day One ... qualifications:** o Recent, relevant experience in a Medicare-certified home health agency as a case - manager o Bachelors degree in nursing o Home Health Case… more
- HCA Healthcare (Gainesville, FL)
- …for education, accountability, elevation of professionalism in partnership with Director and Manager of Case Management. + Communicates potential/actual need for ... Worker is to ensure that primary operations of the Case Management Department function efficiently. This position maintains a...for Social Workers based on appropriate level of care, utilization of services and plan of care. Ensures equitable… more
- Sharecare (Tallahassee, FL)
- …days of training. PTO needs during the training period will be evaluated on a case by case basis and must be approved in advance._ **Compensation:** $22.00/hour ... / new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, dental, and… more