- ChenMed (Miami, FL)
- …experience in Hospital medicine preferred + At least one (1) year of utilization review experience preferred We're ChenMed and we're transforming healthcare for ... our team. The Physician Reviewer is the primary physician reviewer for Utilization Management/Clinical Appropriateness review cases in our organization. Other… more
- General Dynamics Information Technology (Hurlburt Field, FL)
- …as assigned by the HP program Manager and/or Coordinator. + Documents care provided, work performed, utilization , referrals, and all other information in the ... scope of practice. + Participates in periodic meetings to review the care provided to patients to...improvement. + Serves as advisor to the HP program Manager and/or Coordinator in matters related to injury prevention,… more
- Elevance Health (Miami, FL)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... foundation upon which we are creating greater access to care for our members, greater value for our customers,...reviews with attending physicians or other providers to discuss review determinations and patient's office visits with providers and… more
- HCA Healthcare (Kissimmee, FL)
- …auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. + Free counseling ... assistance. + Referral services for child, elder and pet care , home and auto repair, event planning and more...in the pharmacy when the tech supervisor or pharmacy manager is unavailable. + Under the supervision of Director… more
- Elevance Health (FL)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... health medical services, to ensure the appropriate and most cost-effective medical care is received. May be responsible for developing and implementing programs to… more
- Molina Healthcare (St. Petersburg, FL)
- …role must complete courses required to obtain licensure in all states. + Utilization Review Lead responsibilities also include but not limited to, collaborate ... in Nursing preferred. **Preferred Experience** 3-5 years clinical practice with managed care , hospital nursing, utilization and/or care management… more
- CenterWell (Jacksonville, FL)
- …in patient experience, quality of care , clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify opportunities in ... of health (SDOH) efforts, improving clinical outcomes and avoidable utilization + Monitor and manage daily patient care...and monitor clinical & financial performance and metrics. + Review clinician schedules and incentive plans to align with… more
- CenterWell (Daytona Beach, FL)
- …in patient experience, quality of care , clinical outcomes, and avoidable utilization *Periodically review clinician charts to identify opportunities in ... and social determinants of health (SDOH) efforts, improving clinical outcomes and avoidable utilization *Monitor and manage daily patient care and initiatives to… more
- MyFlorida (Monticello, FL)
- …(https://compcalculator.myflorida.com/) Your Specific Responsibilities: CLINICAL DUTIES : + Skilled Nursing Care : Ensures provision of skilled nursing care to ... administration/self-administration of medications to and by students; implementation of ordered care plans; and assessment and screening for student health risks and… more
- HCA Healthcare (Palm Harbor, FL)
- …As a Director Physician Services I with HCA Healthcare, you can be a manager in an organization that is devoted to giving! **Benefits** HCA Healthcare, offers a ... auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. + Free counseling… more