- ChenMed (Opa Locka, FL)
- …facilities. + Maintains clinical and progress notes for each patient receiving care and provides progress report to PCP and others as appropriate. + Submits ... + Participates in surveys, studies and special projects as assigned. + Conducts concurrent medical record review using specific indicators and criteria as… more
- AdventHealth (Altamonte Springs, FL)
- …support of Utilization Management, the Physician Advisor is responsible for providing clinical review of utilization, claims management, and quality assurance ... value you will bring to the team:** + Provides clinical support/validation for both Utilization Management and Care... questions from Utilization Management staff involved in authorizations, concurrent review , and denials + Assists with… more
- CVS Health (Tallahassee, FL)
- …+ 1 year of varied UM (utilization management) experience within an **outpatient** setting, concurrent review or prior authorization. + 5 years of a variety ... + 1 year of varied UM (utilization management) experience within an inpatient, concurrent review or prior authorization. + Remote work experience. **Education**… more
- AdventHealth (Riverview, FL)
- …appropriate leaders for analysis and corrective action to improve quality outcomes. Assures concurrent review is performed on those patients that may trigger ... that will provide community members convenient access to expert care . AdventHealth Riverview will offer a wide range of...organizational status in relation to assigned core measure(s) Performs concurrent data review and rounding for assigned… more
- Cardinal Health (Tallahassee, FL)
- …to rethink the reach and impact of their products. **_What Individualized Care contributes to Cardinal Health_** Clinical Operations is responsible for ... (TM) Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy… more
- Actalent (Sunrise, FL)
- …+ Managed care + Patient care + Medical record + Case management + Concurrent review + Discharge planning + Medical + Acute care Additional Skills & ... + Prepare and present reports on department activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management +… more
- Healthfirst (FL)
- …coordinates the care plan for assigned members and conducts pre-certification, concurrent review , discharge planning, and case management as assigned. The ... Monitors assigned case load to meet performance metric requirements + Functions as a clinical resource for the multi-disciplinary care team in order to maximize… more
- AdventHealth (Tampa, FL)
- …AdventHealth Division AdventHealth Tampa, a faith-based not-for-profit 626-bed tertiary-level acute care hospital located in the uptown district of Tampa, Florida, ... also located at AdventHealth Tampa, leads the way in clinical and academic research in the areas of neuroscience,...legitimacy of hospital admission, treatment, and appropriate level of care . The UM RN leverages the algorithmic logic of… more
- CVS Health (Tallahassee, FL)
- …timely and consistent responses to members and providers related to precertification, concurrent review , and appeal request. This position is primarily ... Management, including prior authorization and precertification as well as concurrent review . Cases could focus on inpatient...+ Five or more years of experience in Health Care Delivery System eg, Clinical Practice and… more
- Sedgwick (Orlando, FL)
- Taking care of people is at the heart of...and employer. + Refers cases to team lead and clinical case management for additional review when ... everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having… more