- Elevance Health (Miami, FL)
- …high quality, cost effective care through assessing the medical necessity of inpatient admissions and extensions of stay, outpatient services, out of ... ** Nurse Care Manager I** **Carelon Services**...health/discharge planning experience preferred. + AS or BS in nursing preferred. + Certification as a Case Manager… more
- Gentiva (Miami, FL)
- …process on referred patients in emergency cases, as staffing indicates, and for inpatient hospice admissions + Provides accurate and timely information regarding ... care for everyone, so we offer ongoing professional training, lower nurse -to-patient ratios, and comprehensive benefits for eligible employees. Here, you'll join… more
- Elevance Health (Miami, FL)
- …coding and documentation patterns such as inappropriate billing for readmissions, inpatient admission status, and Hospital-Acquired Conditions (HACs). + Suggests ... Related Group Clinical Validation Auditor** is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions… more
- Elevance Health (Miami, FL)
- …work. + Determines contract and benefit eligibility; provides authorization for inpatient admission , outpatient precertification, prior authorization, and post ... requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification and data...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Miami, FL)
- …work. + Determines contract and benefit eligibility; provides authorization for inpatient admission , outpatient precertification, prior authorization, and post ... given. + Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care. +...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more