Case Manager POOL

Larkin Community Hospital

Miami, FL

Job Summary:

Seeking an experienced case manager with +5 years of experience in an acute hospital setting.

Qualifications:

Experience
- 5+ years of experience in managed care
- Substantial clinical experience
Education
- Bachelor's degree (required)
- Masters (preferred)
Licensing
- Foreign Medical Graduate or Registered Nurse (preferred)
- CCM (Certified Case Manager) (preferred)
- ACM (Accredited Case Manager) (preferred)
Bilingual (English/Spanish) (preferred)

Responsibilities:

Performs and documents patient assessment within 24 hours of admission
Checks prior authorizations initiative by admitting
Knowledge navigating and using payer portals
Performs concurrent reviews
- Contacting all HMO's on a daily basis and provides clinical information to obtain insurance authorization for the patient's admission and continued stay
Indicates the appropriate level of care and utilization of services needed
Establishes criteria for medically necessary services
- Knowledgeable of Milliman Care and Interqual Guidelines
Develops a plan of care for patients from admission to discharge.
Promotes the most efficient and cost-effective use of services
Curtails the performance of inappropriate and/or duplicate services
Encourages standardization of medical practice patterns
Enhances the quality of healthcare
Performs concurrent reviews for patients to ensure that extended stays are medically justified and are documented in patient's medical records.
Calculates and manages the lengths of stay and continued-stay days for patients.
Evaluating the patient's condition and readiness for discharge planning
Develops discharge plans
Communicate and assist the physicians in the planning and coordination of patients discharge planning
Management of transfer procedures
Management of the guardianship process
Able to discuss and educate patient/family regarding discharge planning and resources available after discharge. Clearly specifies all the information discussed with the patient and/or family regarding the patient's discharge plan.
Participates in PI programs through the identification of opportunities for improvement, data collection, evaluation of findings, improving the process, applying knowledge and incorporates into practice
Scheduling Peer-to-Peer reviews with payors
Proactively identifying and resolving issues that could lead to denials

Skills:

Familiarity with Medhost electronic medical records
Extensive medical knowledge
Self-driven (work and education)
Keeps knowledge up to date by reading literature and participating in outside continued education meetings, training, and conferences
Working knowledge of regulatory agencies
Excellent human relations and communication skills (verbal and written) to maintain good rapport and effective working relationships with medical staff, nursing staff, and other ancillary department staff throughout the hospital
Excellent organizational skills and attention to detail
Ability to convey care plan to physicians and the medical team
Proficient with Microsoft Office Suite or related software.
Integrity

Apply

Vacancy posted 2 days ago

Similar jobs that could be interesting for youBased on the Case Manager POOL in Miami, FL vacancy

Registered Nurse Case Manager, Case Management, Per Diem, Shift Varies
$47 per hour
...Baptist Health Pool RN Case Manager The purpose of the Pool RN Case Manager position is to support the physician and interdisciplinary team in facilitating patient care, with the underlying objective of enhancing the quality of clinical outcomes and patient satisfaction...
Suggested
Daily paid
Shift work
IntelyCare
Miami, FL
3 days ago
SNAP® Case Manager
...where children are safe, families are strong, and communities are vibrant . LSF is looking for a talented SNAP® Case Manager who wants to make an impact in the lives of others. Purpose and Impact: The SNAP® Case Manager is responsible for the day...
Suggested
Full time
Work at office
Local area
Remote work
Afternoon shift
Lutheran Services Florida
Miami, FL
4 hours ago
Personal Injury Case Manager
(Hiring) Personal Injury Case Manager We are seeking a Case Manager to become a part of our team! You will provide overall support to attorneys' business needs. Responsibilities: Conduct research to support legal proceedings Assist with the pre litigation...
Suggested
Viper Staffing Services L.L.C.
Miami, FL
3 days ago
Case Manager (50914)
...Position Summary: The Case Manager plays a vital role in supporting children and families involved in the child welfare system. This position ensures the safety, well-being, and permanency of children who have been removed or are at risk of removal from their homes...
Suggested
Work at office
Local area
Immediate start
Trial period
Flexible hours
Afternoon shift
WestCare
Miami, FL
20 hours ago
Child Welfare Full Case Manager
$52k - $60k
Job Posting Location 1393 Southwest 1st Street, Miami, FL, 33135, United States Base Pay $52,000.00 - $60,000.00 / Year Job Category Child Welfare Social Work Employee Type FT Non-Exempt Contact Information Name Claudia Rincones Phone (***) ***-**** ...
Suggested
FRC Florida
Miami, FL
3 days ago
Case Manager
...please review this tip sheet ( . The University of Miami's Department of Psychology has an exciting opportunity for a full-time Case Manager to work in Miami Lakes, FL. The Center for Autism and Related Disabilities (CARD) has an open Case Manager position to work...
Full time
Temporary work
Work experience placement
Local area
Night shift
Weekend work
Afternoon shift
University of Miami
Hialeah Gardens, FL
3 days ago
Personal Injury Intake Case Manager
...Description This is a full-time position on-site Monday - Friday at our office in Miami Lakes, FL Role Overview The Intake Case Manager plays a critical role in managing pre-litigation personal injury cases from intake through treatment progression and case...
Full time
Temporary work
Work at office
Immediate start
Monday to Friday
The Ward Law Group, PL
Hialeah Gardens, FL
1 day ago
Case Manager Supervisor (50730)
...Position Summary: The Case Manager Supervisor provides leadership and oversight to a team of Case Managers responsible for ensuring the safety, well-being, and permanency of children and families involved in the child welfare system. This role ensures compliance...
Work at office
Local area
Immediate start
WestCare
Miami, FL
1 day ago
Case Manager
...Case Manager Miami, Florida, United States At Morgan & Morgan, the work we do matters. For millions of Americans, we're their last line of defense against insurance companies, large corporations or defective goods. From attorneys in all 50 states, to client support...
Full time
Local area
Morgan & Morgan
Miami, FL
1 day ago
Case Manager
...Case Manager Career Opportunity Clinical License Required Recognized for your abilities as a Case Manager Are you ready for a Case Management role that brings your career closer to home and heart? Join Encompass Health, where being a Case Manager goes beyond...
Full time
Contract work
Part time
Flexible hours
Encompass Health Rehabilitation Hospital of Katy
Cutler Bay, FL
4 days ago
Mobile MAT Case Manager (51009)
...provide needs assessments and develop and participate in care management plan development and implementation. Will advocate on the individual... ...of supportive services, such as mental health counseling, case management, risk reduction education, and referrals to additional...
Work at office
Local area
Immediate start
Remote work
Flexible hours
Afternoon shift
WestCare
Miami, FL
1 day ago
Case Manager Immigration Bilingual Spanish
...ISAP Case Manager Since inception in 2004, BI Incorporated has operated ISAP for the Department of Homeland Security (DHS) and U.S. Immigration and Customs Enforcement (ICE) and Enforcement and Removal Operations (ERO). ISAP is an essential part of ERO, providing intensive...
Contract work
Live in
Work at office
Local area
GEO Group
Miami Lakes, FL
3 days ago
Case Manager
...accountability, ensuring clients are empowered to achieve their housing, income, and wellness goals. What You'll Do As a Case Manager, you will provide intensive case management and supportive services to guests in our residential treatment program who have co-...
Temporary work
Work at office
Flexible hours
Afternoon shift
Camillus House
Miami, FL
1 day ago
Case Manager - Long Term Care
...Spanish Position Summary: ~ Provide comprehensive healthcare management services to facilitate appropriate healthcare treatment,... ...am-5:00pm, standard business hours. Duties: Coordinates case management activities for Medicaid Long Term Care/Comprehensive...
Full time
Contract work
Work at office
Monday to Friday
SGS Consulting
Doral, FL
4 days ago
Refugee Case Manager - Miami (Temporary)
$24.52 per hour
...Refugee Case Manager This is a temporary position, effective through March 1, 2026 - August 14, 2026. Are you excited by the prospect of working for an organization that truly values your contributions, provides opportunities for growth and development, AND gives...
Hourly pay
Temporary work
Internship
Local area
Immediate start
Flexible hours
Gulf Coast JFCS
Miami, FL
4 days ago
Case Manager
...notes into database for Head Start • Responsible for the overall management of the Center's Food Program to include but not limited to... ...families as per the family assessment questionnaire • Follows up on cases and complete a minimum of one monthly progress note for FPA •...
Catholic Charities
Miami, FL
1 day ago
Case Manager - Psychology
...Case Manager The University of Miami's College of Arts and Sciences has an exciting opportunity for a full time Case Manager to work in Coral Gables, University of Miami-Nova Southeastern University Center for Autism & Related Disabilities (CARD). The University...
Full time
Work experience placement
Local area
Work from home
Night shift
University of Miami
Miami, FL
3 days ago
LTC Case Manager, FL PACE Centers
...their families. The following Job Description will also apply at Broward Pace Program sites. Job Title: Social Services Case Manager (Florida PACE Centers) Job Summary Responsible for providing structured case management, Level of Care (LOC) assessment...
Full time
Part time
Local area
Miami Jewish Health
Miami, FL
2 days ago
CASE MANAGER
$22.6 per hour
...Case Manager Join a group of passionate advocates on our mission to improve the lives of youth! Rite of Passage Team is hiring for a Case Manager at South Florida Youth Academy in Miami Beach, Florida. Located in beautiful Miami, Florida, our workplace offers the...
Hourly pay
Trial period
2 days per week
Rite of Passage Brand
Miami, FL
1 day ago
Bilingual LTC Case Manager
...Job Description Job Description Job Title: Case Manager/Healthcare Consultant I Location: “Miami Dade County, FL”. (25% Remote and 75%Travel). Hours: Monday - Friday: 8 am - 5 pm EST Pay Rate: $30-$32/hr. on W2 (without benefits) + (Mileage Reimbursement...
Work at office
Remote work
Monday to Friday
SGS Consulting
Miami, FL
3 days ago
WSC or Case Managers
...Job Description Job Description Duties as a Case Manager. Must be approved by APD/ AHCA and the State of Florida. This is a vacancy that takes 3 or 4 months to be approved by State of Florida. Responsibilities includeCost Plan management (Working with IConnect)., Creating...
Contract work
Advanced Support Coordination Servi
Hialeah, FL
2 days ago
Case Manager - Imigração Americana (Business Immigration)
...Descrição da Vaga Case Manager – Imigração Americana (Business Immigration) A Piquet Law Firm, escritório de advocacia sediado em Miami, Flórida, está contratando Case Managers no Brasil para atuar em casos de imigração empresarial e profissional para os Estados...
H1b
Remote work
Piquet Law Firm, P.A.
Miami, FL
2 days ago
Medicaid Case Manager - Care Coordination & Quality
A global staff augmentation firm is seeking a healthcare management professional in Miami. The role involves coordinating care management... ...and maintaining quality metrics. The ideal candidate will have case management experience, be bilingual in Spanish and English, and...
Work at office
Remote work
US Tech Solutions
Doral, FL
6 days ago
Lemon Law Paralegals, Case Managers & Intake Specialist
...Lemon Law Paralegals, Case Managers & Intake Specialist We are seeking a Lemon Law Paralegals, Case Managers & Intake Specialist to become a part of our team! You will provide overall support to attorneys' business needs. Responsibilities: Conduct research...
Viper Staffing Services L.L.C.
Miami, FL
3 days ago
Healthcare Case Manager
...Job Summary: ~ Provide comprehensive healthcare management services to facilitate appropriate healthcare treatment, effectively manage... ...most appropriate level Responsibilities: Coordinates case management activities for Medicaid Long Term Care/Comprehensive...
Work at office
Remote work
Varite
Miami Beach, FL
3 days ago
Residential Case Manager
$24 - $26 per hour
...Residential Case Manager $24-$26 Hourly (Mon-Fri 9:00 a.m. - 5:00 p.m.) We are looking for a Case Manager to enhance the quality of our client management, maximize satisfaction and promote cost effectiveness. The successful candidate will be accountable for the full...
Hourly pay
Contract work
Agape Network
Miami, FL
24 days ago
HOUSING CASE MANAGER
...ESSENTIAL JOB RESPONSIBILITIES Housing Case Manager Conduct comprehensive interviews and complete intake assessments to determine eligibility for Day 1 Family Fund programs and local housing resources, identifying both short-term and long-term housing needs...
Permanent employment
Temporary work
Work experience placement
Work at office
Local area
Flexible hours
Care Resource
Miami, FL
13 days ago
Senior Case Manager - Acute Hospital Care
Larkinorthopedics in Miami, Florida is looking for an experienced case manager with over 5 years of experience in managed care. The role requires a bachelor's degree and preferred certifications in nursing or case management. Responsibilities include patient assessment...
Larkinorthopedics
Miami, FL
20 hours ago
Field-Based Bilingual LTSS Case Manager
The Elevance Health Companies, Inc. in Miami is looking for a dedicated LTSS Service Coordinator - Case Manager to provide comprehensive service coordination for individuals in LTSS programs. This field-based position requires residency in or near designated counties and...
Work experience placement
The Elevance Health Companies, Inc.
Miami, FL
4 days ago
CASE MANAGER
$22.6 per hour
..., NW 35th St. Entrance, Miami, FL 33142, USA (On-site) Rate: $22.60 per hour Job Description Rite of Passage Team is hiring a Case Manager to support the development and facilitation of case plans and treatment programs for students. The case manager will collaborate...
Hourly pay
Full time
Trial period
Rite of Passage Brand
Miami, FL
1 day ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Case Manager POOL. Be the first to apply!