- Molina Healthcare (Orlando, FL)
- …Utilization Management, Chief Medical Officer, Physicians, and Member/Provider Inquiries/ Appeals . + Provides training, leadership and mentoring for less ... **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct...has been made or upon request by another Molina department to reduce the likelihood of a formal appeal… more
- CBRE (Miami, FL)
- Valuations Funds Manager Job ID 215005 Posted 11-Apr-2025 Service line Advisory Segment Role type Full-time Areas of Interest Valuations/Appraisal Location(s) Miami ... - United States of America **About The Role:** As a CBRE Valuation Funds Manager , you will independently prepare market value appraisals on real estate assets with… more
- Evolent (Tallahassee, FL)
- …to the support services review process. Responsible for the quality of utilization review determinations, including appeals . + Provides input into audit ... training classes as needed for new hires to educate and train on Utilization management system and Field Medical Director process, standards and resources. + Acts… more
- Elevance Health (Naples, FL)
- …resolution through direct contact with providers, claims, pricing and medical management department . + Identifies and reports on provider utilization patterns ... issues impacting provider satisfaction, researches and resolves complex provider issues and appeals for prompt resolution. **How you will make an impact** Primary… more
- Elevance Health (Miami, FL)
- …of all prior authorization determinations. + Provides resolution to grievances and appeals issues. + Responds to inquiries from physicians, the sales team, and ... formulary and prescription benefits. + Generates reports relating to rebates, physician utilization , Beers Criteria, Reliance members, and other ad hoc reports. +… more