- Molina Healthcare (Jacksonville, FL)
- …and facilitates root cause analyses. + Leads internal audits and file review rehearsals. + Ensures survey readiness by maintaining documentation and evidence of ... in healthcare, with 2+ years in health plan quality improvement or managed care . (HIGHLY PREFERRED)** + **Strong knowledge of NCQA standards and EQRO functions.… more
- University of Miami (Miami, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Sr. Research ... methods. The person will supervise and train users to ensure proper instrument utilization and ensure good laboratory standards for the facility. The person will… more
- ChenMed (Jacksonville, FL)
- …and explain nurse practitioner role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... your kindness and joy? We're different than most primary care providers. We're rapidly expanding and we need great...practice. + Other duties as assigned and modified at manager 's discretion. KNOWLEDGE, SKILLS AND ABILITIES: + Demonstrated record… more
- AdventHealth (Maitland, FL)
- …understanding of specialty medications and a passion for providing high-quality patient care . Some key responsibilities for this role include managing and overseeing ... nurses, and other pharmacists to ensure coordinated and effective patient care . Additionally, they will educate patients about their medications, monitor patient… more
- AdventHealth (Orlando, FL)
- …patient tower and 80 new private rooms designed to enhance the holistic care experience + Annual number of emergency cases: 89,018 **The role you'll contribute:** ... pharmacy, and/or satellite pharmacy areas. Oversees and ensures appropriate utilization of medication automation, technology, and computer systems. Accurately… more
- AdventHealth (Orlando, FL)
- …pharmacy, and/or satellite pharmacy areas. Oversees and ensures appropriate utilization of medication automation, technology, and computer systems. Accurately ... + Pharmacy Practice Completes critical medication order scrutiny, drug profile review , and patient monitoring to identify, prevent, or mitigate medication-related… more
- Elevance Health (Miami, FL)
- …clients/ members. The medical director provides clinical expertise in all aspects of utilization review and case management. Provides input on the clinical ... for serving as the Operational Medical Director for our care management models for our National Account clients. The...state or territory of the United States when conducting utilization review or an appeals consideration and… more
- Elevance Health (Miami, FL)
- …Plans, Freedom Health, and Optimum Healthcare Plans and will be responsible for utilization review case management for these markets. May be responsible for ... advisor to enhance clinical operations. May identify cost of care opportunities. May serve as a resource to staff...state or territory of the United States when conducting utilization review or an appeals consideration and… more
- Molina Healthcare (Orlando, FL)
- …Qualifications * Experience with utilization /quality program management. * Managed care experience. * Peer review experience. * Certified Professional in ... and clinical leadership for health plan and/or market specific utilization management and care management behavioral health...Healthcare Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager … more
- KBR (Elgin AFB, FL)
- …current with the provision of care . + Provide input for the development and utilization of required databases. + Conduct peer (record) review s for the HP ... . We maintain a highly qualified workforce to help care for service people and astronauts across the world...POTFF Staff, and as directed by local HP program manager and/or coordinator. + Document work performed, utilization… more