- Centene Corporation (Tallahassee, FL)
- …Statewide** **Position Purpose:** Supervise the day to day operations of the case management function. Communicate with departmental and plan administrative ... staff. + Assure compliance with established onsite and concurrent review, case management , referral, pre-certification and authorization policies, procedures and… more
- CVS Health (Tallahassee, FL)
- …Manager is responsible for telephonically assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical ... impact functionality. - Reviews prior claims to address potential impact on current case management and eligibility. - Assessments include the member's level of… more
- CVS Health (Tallahassee, FL)
- …Care Manager is responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs ... in overcoming barriers in meeting goals and objectives, presents cases at interdisciplinary case conferences. + Utilizes case management processes in… more
- Centene Corporation (Tallahassee, FL)
- …federal and state regulations. This role will be responsible for supporting the care management team through case file reviews and monthly audit review of the ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
- Centene Corporation (Tallahassee, FL)
- …+ Identify processes and work flow improvements to foster efficient and effective case management efforts + Monitor distribution of members identified for ... case management to ensure positive results and program success **Education/Experience:** High school diploma or equivalent. 5+ years of prior authorization,… more
- MyFlorida (Tallahassee, FL)
- …or Court Action is available to update SAO information. Add appropriate documentation to the case management system. + Assist supervisor with the review of ... Please read below: + Please include the names and phone numbers for the supervisor (s) and/or Human Resource Department for all periods of employment. + Account for… more
- Marriott (Tallahassee, FL)
- …concern in this position. **SCOPE/EXPECTED CONTRIBUTIONS** **Scope** + Provides telephonic case management of associates with occupational illness/injuries to ... Case Managers. **Claims Services** + Collaborate with Claims department regarding case management . + Collaborate with UNM on utilization review issues. +… more
- MyFlorida (Tallahassee, FL)
- …II works in the area related to the regulation of educator licensure, investigations, case management , data management , and the development and delivery of ... The omission of specific job duties does not preclude management from assigning specific duties not listed herein if...responsibilities. * Ensures all data and benchmarks of a case are accurately maintained and recorded. * Assists in… more
- MyFlorida (Tallahassee, FL)
- …IV works in the area related to the regulation of educator licensure, investigations, case management , data management , and the development and delivery of ... The omission of specific job duties does not preclude management from assigning specific duties not listed herein if...responsibilities. + Ensures all data and benchmarks of a case are accurately maintained and recorded. + Assists in… more
- MyFlorida (Tallahassee, FL)
- …+ Prepares and tracks status of invoices + Advises Public Records Office Supervisor of current and potential issues related to requests or public records office ... requests. + Administrative Support + Provide administrative support to the unit Supervisor and other assigned attorneys including: + Assists in conducting daily… more
- J&J Family of Companies (Tallahassee, FL)
- …a commutable distance of Irvine, CA however remote options will be considered on a case -by- case basis_ . **About Johnson & Johnson** At Johnson & Johnson, we ... peer-reviewed journal articles. His/her work will follow guidance from Biostatistics management and will adhere to applicable regulations for pre- and post-market… more
- CVS Health (Tallahassee, FL)
- …themselves. They are responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical ... overcoming barriers in meeting goals and objectives, presents cases at interdisciplinary case conferences* Utilizes case management processes in compliance… more
- MyFlorida (Tallahassee, FL)
- …(1) year experience using the Florida System and knowledge in resolving Florida Case problems. Minimum of one (1) year experience in a strategic customer ... related programs, ie AMS, DVS, etc. Also, knowledge in resolving Florida Case problems and determining eligibility in the Florida Application. This position is… more
- MyFlorida (Tallahassee, FL)
- …write interrogatories, or perform any other discovery technique necessary to prosecute a case . + Conduct or supervise legal research, writing of legal memoranda, or ... perform other duties necessary to prosecute a case . + Consult with the Commissioner regarding disciplinary action...or more* + Education + Volunteer Experience + Include supervisor names and phone numbers including current place of… more
- Sedgwick (Tallahassee, FL)
- …of highly complex nature and/or high exposure surety claims; to coordinate case management within Company standards, industry best practices and specific ... and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim...coding is correct. + Refers cases as appropriate to supervisor and management . + Delegates work and… more
- CenterWell (Tallahassee, FL)
- …+ Set or adopt policies for, and keep records of criteria for admission to service, case assignments, and case management . + Represent the pharmacy in a ... the following key functions: + Program evaluation + Risk Management + Utilization Review + Patient Care Evaluation +...create and + Perform other duties as assigned by supervisor . Required Qualifications + Graduate of an accredited school… more
- Lumen (Tallahassee, FL)
- …the underlying assumptions of those cases. The role works with varying levels of management on other requests as necessary and with various teams to validate data ... special ad hoc reports and perform analysis as requested by supervisor , business partners/clients, and other Business Unit stakeholders + Improve partnerships… more
- MyFlorida (Tallahassee, FL)
- …+ Responsible for securing, evaluating and documenting evidence. + Opening case files in Versa Regulation and prepares written, detailed investigation reports. ... 61D, Florida Administrative Code. + Briefing and advising the Investigative Supervisor and Chief of Investigations regarding active investigations and developing… more
- Wolters Kluwer (Tallahassee, FL)
- …(OEM) partnerships and alternative sales channel partnerships that in each case deliver long-term profitable growth for CSCD (expected to be predominantly ... each audience. **Other Duties** Performs other duties as assigned by supervisor . **Job Qualifications** Education: College degree (BA/BS) required. MBA is… more
- MyFlorida (Tallahassee, FL)
- …positions available. Department of Children and Families Programs & Project Management Consultant - GOVERNMENT OPERATIONS CONSULTANT II - 60070536 Strategic Programs ... relevant equivalent work experience. + Experience working in an emergency management /disaster response and recovery capacity, which should consist of directly… more