- 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
- Sedgwick (Tallahassee, FL)
- …While partnering with the injured worker, employer, and medical providers, create a case management strategy to facilitate medical recovery and a successful ... accredited college or university or equivalent work experience preferred. Certification in case management , rehabilitation nursing or a related specialty is… more
- MyFlorida (Tallahassee, FL)
- LEGAL SUPPORT SUPERVISOR - TALLAHASSEE - 41000789 Date: May 8, 2024 Location: TALLAHASSEE, FL, US, 32399 The State Personnel System is an E-Verify employer. For more ... and keeping staff current on procedural changes. + Assist with coordinating correspondence, case records and assignments. + Assist the Bureau Chief and Investigator … 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)
- …conditional release and education and employment stipulations. JOB DESCRIPTION : Case Management , Referrals, Recommendations and Assessment Initiate contact with ... and any Department approved risk/needs screening and/or assessments instrument(s). Formulate case management strategies based on assessments and/or information… more
- Marriott (Tallahassee, FL)
- …concern in this position. **SCOPE/EXPECTED CONTRIBUTIONS** Scope + Provides telephonic case management of associates with occupational illness/injuries to ... Field Case Managers. Claims Services + Collaborate with Claims department regarding case management . + Collaborate with UNM on utilization review issues. +… 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
- 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)
- …and release date calculation and is in compliance with Florida Statutes and Case Laws. + Verifies tentative release dates by manual computation procedures. + ... the Court Staff to clarify sentence structure, if needed. + Assist Supervisor with code/load/emergency/upfront time served new commitments. + Assists with preparing… 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 (Quincy, FL)
- …work in cooperation with the Program Administrator, APS supervisors and regional management in promoting the development of knowledge, skills and application to ... case activities. EXAMPLES OF WORK Provide support to field...performance observations. Serve investigations and services through an "Acting Supervisor " role, as assigned; providing temporary coverage when supervisors… 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
- MyFlorida (Tallahassee, FL)
- …position reports directly to the OPBI's Public Assistance Fraud Reward Program's supervisor located in the Headquarters Office in Tallahassee, Florida. The position ... referrals for issues or complaints and communicates issues and/or problems to supervisor . Responds to complainants as necessary and in a timely. Submits fraud… 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)
- …Word Templates. + Must possess knowledge of application support, particularly the AWARE case management system. + Must have general working knowledge of adaptive ... system updates (ie AWARE upgrades, Social Security Application, Rehab Center Management , National Voter Registration App, Federal Reporting, etc.) + Coordinates user… more