- Cleveland Clinic (Vero Beach, FL)
- …one year of eligibility (CTM, ACM, CCM or AHA) + 2 years of recent experience in utilization review , quality or care management + Knowledge of acute care ... Treasure Coast where it is committed to providing optimal family-centric and community-focused care . At Indian River Hospital, you will be part of a collaborative,… more
- Parsons Corporation (Fort Myers, FL)
- …looking for. **Job Description:** Parsons is looking for an amazingly talented **Construction Manager with airport experience** to join our team! In this role you ... + Ability to work efficiently with minimal supervision under pressure + Ability to review and manage construction contracts + Ability to negotiate and manage risks +… more
- Crane Aerospace & Electronics (Fort Walton Beach, FL)
- …Aerospace and Electronics** has an exciting opportunity for a **Test Engineering Manager ** at our **Fort Walton beach, FL** location. **About Crane:** **Crane ... and requirements. + Ensure accurate program accounting is achieved through effective utilization of project records and data management. + Define and manage… more
- Amergis (Gainesville, FL)
- …and local requirements + Must be at least 18 years of age + Experience with Utilization Review Benefits At Amergis, we firmly believe that our employees are the ... Salary: $1800 / Week The RN Case Manager is responsible for coordinatingcontinuum of care...Case Manager is responsible for coordinatingcontinuum of care activities for assigned patients and ensuring optimumutilization of… more
- Molina Healthcare (Miami, FL)
- …bills, and claims data to ensure appropriate payment levels, optimize resource utilization , and maintain compliance with state and federal laws. All reviews must ... with a consistent focus on promoting the quality, accuracy, and efficiency of review services. + Serve as a resource and subject matter expert to colleagues… more
- BayCare Health System (Bradenton, FL)
- …agency staff. + Participates with Case Manager on initial Plan of Care review with a focus on quality, utilization and individual patient care goals. ... bodies within the area of responsibility. + Ensure quality assurance program and utilization review is followed in accordance with Home Care protocol. +… more
- AdventHealth (Maitland, FL)
- …and Multi-state Physician Contract Administration team. This team is responsible for contract review ; as well as, the building and maintenance of rates and terms ... within Patient Financial Services (PFS), Physician Practice leadership and Managed Care staff regarding contract interpretation and the implementation and operation… more
- AdventHealth (Port Charlotte, FL)
- …pediatric units in Charlotte County. **The role you'll contribute** **:** The RN Care Manager in collaboration with the patient/family, social workers, nurses, ... care coordination and progression through the continuum of care . The RN Care Manager ...physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge… more
- Sharecare (Tallahassee, FL)
- …individual through the lens of their personal health and making high-quality care more accessible and affordable for everyone. To learn more, visit ... services + Uses technical and business development skills to increase client's utilization of current technology + Tracks, analyzes, creates, and delivers relevant… more
- Elevance Health (Tampa, FL)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... is granted as required by law. The **Medical Director-Primary Care Appeals** is responsible for the review ...and quality. + Work independently with oversight from immediate manager . + May be responsible for an entire clinical… more