- Molina Healthcare (Miami, FL)
- …(provider/plan profiling, member drug profile reviews, medication protocols/criteria, and case -by- case interventions). * Articulates pharmacy management policies ... authorization requests as needed. * Researches, develops, and implements drug utilization and disease state management strategies and intervention techniques to… more
- Elevance Health (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 (Orlando, FL)
- **Registered Nurse Case Manager AdventHealth Home Health** **All the benefits and perks you need for you and your family:** + Up to $5,000 Sign on Bonus + ... Degree in nursing + Recent, relevant in a Medicare-certified home health agency as a case - manager + COS-C - Certificate for OASIS Specialist - Clinical + Home… 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
- Lumen (Tallahassee, FL)
- …show value and improvement for technologies and processes. + Create and analyze utilization statistics of systems to identify causes for system degradations as well ... as recommend required system enhancements for business case and budget approval. + Perform upgrading, patching, hardening, user access permissions, and routine… more
- AdventHealth (Winter Haven, FL)
- **Registered Nurse Case Manager - AdventHealth Home Health** **All the benefits and perks you need for you and your family:** + Up to $10,000 Sign on Bonus + ... Nursing + Recent, relevant experience in a Medicare-certified home health agency as a case - manager + Home Health Case - Manager Certification + Certificate… more
- AdventHealth (Minneola, FL)
- …health setting and critical care **LICENSURE, CERTIFICATION, OR REGISTRATION PREFERRED:** + Case Management certification Accredited Case Manager (ACM) + ... patients who are at high-risk for readmission or high emergency room utilization . Evaluates practice upon completion of case intervention, determining whether… more
- Molina Healthcare (FL)
- …License must be active and unrestricted in state of practice. * Certified Case Manager (CCM), Certified Professional in Health Care Management certification ... supporting one or more of the following functions: care management, utilization management, care transitions, long-term services and supports (LTSS), behavioral… more
- Elevance Health (Miami, FL)
- …mandated policies, and CMS Coverage Determinations, as applicable. + Perform physician-level case review of utilization requests for procedures and interventions ... make an impact:** + Ensures timely completion of clinical case reviews for their board certified specialty. + Makes...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
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