- CenterWell (Tallahassee, FL)
- …member service or customer service telephone experience desired + Experience with Utilization Review and/or Prior Authorization, preferably within a managed ... a part of our caring community and help us put health first** Utilization Management Administration Coordinator II , non-clinical, supports the UM operations by… more
- Elevance Health (FL)
- …+ Demonstrate and maintain knowledge of relevant policies and regulations pertaining to utilization review of oncology care . + Participate on committees ... an impact:** + Perform physician-level case review , following initial nurse review , of Medical Oncology regimens and supportive care . + Perform… more
- ChenMed (Clearwater, FL)
- …Specialty, MED COE and HCT leaders to support improved medical costs and specialty care utilization . This individual will work closely with and consider feedback ... Specialty, MED COE and HCT leaders to support improved medical costs and specialty care utilization . This individual will work closely with and consider feedback… more
- 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
- HCA Healthcare (Gainesville, FL)
- …team. Grow your career with an organization committed to delivering respectful, compassionate care , and where the unique and intrinsic worth of each individual is ... auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. + Free counseling… 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
- 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
- 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
- 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
- ICW Group (Orlando, FL)
- …management issues related to bill review , case management and utilization review . + Works closely with Case Management Manager and Director to perform ... **KNOWLEDGE AND SKILLS** Understanding of Workers' Compensation, Workers' Compensation Managed Care processes, Utilization Review , Telephonic Nurse Case… more