• Nurse Care Manager I - Temporary…

    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
    Elevance Health (03/20/25)
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  • HCT- Data Quality Coordinator (HCT DQC)

    ChenMed (North Lauderdale, FL)
    … and outpatient treatment providers. + Notices health plan partner of all inpatient admissions and discharges and engaging health plan staff in discharge ... care team. This team includes one or more physicians, nurse practitioners, nurse case managers, and social...in care and prevent the need for repeat hospital admissions . Closely collaborates with the Transitional Care Team members,… more
    ChenMed (01/28/25)
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  • RN Clinical Liaison

    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
    Gentiva (03/12/25)
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  • Diagnosis Related Group Clinical Validation…

    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 (03/04/25)
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  • Utilization Management Representative I

    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 (03/20/25)
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  • Utilization Management Representative II

    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
    Elevance Health (03/20/25)
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