- Elevance Health (Tampa, FL)
- …thinking skills and nursing judgment and experience. + Collaborates with case management nurses on discharge planning, ensuring patient has appropriate equipment, ... Educates members about plan benefits and physicians and may assist with case management. + Collaborates with leadership in enhancing training and orientation… more
- Terumo Aortic (Sunrise, FL)
- …+ Creates account specific strategies by geography to drive market acceptance and utilization of Thoracic devices. + Assists with new implanters of Thoracic devices, ... namely Thoraflex, to include in-servicing and initial case support. + Maintains a network of ...strategy in conjunction with Clinical Marketing, Downstream Marketing, and Manager of Medical Education + Actively involved in sales… more
- Prime Therapeutics (Tallahassee, FL)
- …an office or home setting for drug services. + Will actively maintain a required case load and the activities to reach overall goals of switching site of service ... is valued with the program. + Maintains an active case load and accurate case records, adhering...Quality oversight for this program is provided by the Manager , Patient Programs. **Education & Experience** + Associates -… more
- J&J Family of Companies (Naples, FL)
- …Electrophysiology US Field Sales & Service group reporting to a New Technology Manager (NTM), and closely partnering with, the Regional Business Director (RBDs) and ... Territory Managers (TMs). Under the general direction of the manager and in accordance with all applicable federal, state and local laws/regulations and Corporate… more
- MyFlorida (Orlando, FL)
- …eligibility and makes recommendations for licensure to supervisor/regional program manager . + Investigates complaints on licensed providers and illegal child ... + Attains a high proficiency/skill level as demonstrated through the competent utilization of the program's hardware, software, system applications and web pages. +… more
- Molina Healthcare (St. Petersburg, FL)
- …ASSOCIATION:** Certified Clinical Coder, Certified Medical Audit Specialists, Certified Case Manager , Certified Professional Healthcare Management, Certified ... of payment decisions. + Serves as a clinical resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. +… more
- Elevance Health (Tampa, FL)
- …medical necessity of requests using clinical criteria. + Performs physician-level case review of musculoskeletal utilization requests. + Conducts peer-to-peer ... preferred. + Extensive spine surgery experience preferred. + Experience with utilization management, especially with CMS guidelines preferred. + **Orthopedic Spine… more
- BayCare Health System (Lakeland, FL)
- …education regarding the Emergency Management program for office and agency staff. + Participates with Case Manager on initial Plan of Care review with a focus on ... area of responsibility. + Ensure quality assurance program and utilization review is followed in accordance with Home Care...quality, utilization and individual patient care goals. + Knowledge of… more
- CenterWell (Jacksonville, FL)
- …in patient experience, quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify opportunities in care, ... precise + Identify critical issues for high-risk patients during case reviews & other forums, and modeling and driving...of health (SDOH) efforts, improving clinical outcomes and avoidable utilization + Monitor and manage daily patient care and… more
- CenterWell (Daytona Beach, FL)
- …in patient experience, quality of care, clinical outcomes, and avoidable utilization *Periodically review clinician charts to identify opportunities in care, ... coaching initiatives are precise *Identify critical issues for high-risk patients during case reviews & other forums, and modeling and driving clinical excellence… more