- Healthfirst (FL)
- …case management, identifying alternative care options, and discharge planning + Certified Case Manager + Interqual and/or Milliman knowledge + Knowledge of ... **This position is 100% Remote **Duties/Responsibilities:** + Provides case management services for assigned member caseloads which includes: + Pre-certification… more
- Highmark Health (Tallahassee, FL)
- …industry, corporate, state, and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create care plans ... :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides oversight over… more
- HCA Healthcare (Lake City, FL)
- …at HCA Florida Lake City Hospital have the opportunity to make a real impact. As a(an) Case Manager RN PRN you can be a part of change. **Benefits** HCA Florida ... improve positive outcomes for your patients as a (an) Case Manager RN PRN. We want your...condition and insurance company request and documents in the UM module. + Performs initial screening of identified patients… more
- ERP International (Eglin AFB, FL)
- **Overview** ERP International is seeking a **Registered Nurse (RN)** for a full-time ** Case Manager ** position in support of the **Eglin Hospital, Eglin AFB, FL ... databases for community resources. + Integrate CM and utilization management ( UM ) and integrating nursing case management with social work case management. +… more
- University of Miami (Miami, FL)
- …andregulations.4. Maintains study binders and filings according to protocol requirements, UM and department policy.5. Distributes study drug materials according to ... Coordinator, under the supervision of the Principal Investigator and Clinical Manager , will assist in creating, updating, and maintaining the research charts… more
- Healthfirst (FL)
- …with demonstrated ability to handling rapidly changing crisis situations + Knowledge of UM /QM case philosophies and reporting requirements to state and federal ... agencies + Ability to allocate, monitor, and control resources while delegating and monitoring workloads + Ability to effectively manage performance as well as set and achieve goals **Compliance & Regulatory Responsibilities:** + Ensures Care Management team… more
- University of Miami (Miami, FL)
- …Specialist assists in creating, updating, and maintaining research charts and case report forms, including regulatory related issues, in accordance with department ... filings according to protocol requirements and department policy. Adheres to all UM and department policies and procedures. Compiles patient data for Investigator… more
- Molina Healthcare (FL)
- …Certified Clinical Coder + Certified Medical Audit Specialists (CMAS) + Certified Case Manager (CCM) + Certified Professional Healthcare Management (CPHM) ... The Delegation Oversight Nurse is responsible for ensuring that Molina Healthcare's UM delegates are compliant all applicable State, CMS, and NCQA requirements, as… more
- University of Miami (Miami, FL)
- …regulations. + Maintains study binders and filings according to protocol requirements, UM and department policy. + Distributes study drug materials according to ... Specifics: DUTIES & RESPONSIBILITIES: + Assist Principal Investigator and Sr. Manager with assessing feasibility. + Organizes and participates in Study Initiation… more
- University of Miami (Coral Gables, FL)
- …youth development and trauma-informed strategies Coordinate dates and times for Case Manager and caregiver visits to the UM campus, Therapy sessions and ... Court appearances by youth Supervise youth during Summer Academy activities, which may include classroom, off-campus activities, and meal and dorm times. Design and participate in select life skills workshops and team-building activities to teach… more
- Sharecare (Tallahassee, FL)
- …hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management ( UM ) status, including but not limited to medical, dental, and vision ... members to Clinical Advocates (Nurse) for conditions that require clinical care and case management assistance + Primary duties include but are not limited to: +… more
- University of Miami (Miami, FL)
- …and water conservations project opportunities new to the University, prepare business case rationale. + Build, lead, and motivate multiple teams, representing the ... on the creativity and diversity of campus project team members and other UM employees alike. + Supports the business development and management of strategic… more