- Molina Healthcare (FL)
- …authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the denial process. + Monitors appropriate ... local laws and regulatory requirements affecting the medical and clinical staff. MD licenses required for the following states:...includes strategies that ensure a high quality of patient care , ensuring that patients receive the most appropriate … more
- CVS Health (Tallahassee, FL)
- … system is more transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources. In the ... Director you will + Focus primarily on overseeing utilization review / quality assurance and be responsible for predetermination...*Two (2) or more years of experience in Health Care Delivery System eg, Clinical Practice and… more
- AdventHealth (Daytona Beach, FL)
- …AdventHealth, to allow for accurate public reporting of clinical outcomes. Utilizes clinical expertise to review patient care episodes across the ... quality and outcomes to meet accreditation and regulatory requirements. Responsible for ensuring clinical outcomes accurately reflect the care provided at… more
- AdventHealth (Altamonte Springs, FL)
- …FL **The role you will contribute:** Under general supervision of the Clinical Documentation Integrity (CDI) Manager, and in some situations the supervision of ... the Director of Clinical Documentation Integrity, and in collaboration with physicians, nursing...of illness, expected risk of mortality, and complexity of care of the patient. educates members of the patient… more
- HCA Healthcare (Tallahassee, FL)
- …data collection and follow up for multiple quality measures. Abstraction consists of concurrent review of in-house patients for multiple populations; eg, Heart ... of communication especially with clinical staff and clinical leadership - able to influence care ...and clinical leadership - able to influence care with evidence, guidelines, data and teaching/coaching. + Develops,… more
- HCA Healthcare (Orange Park, FL)
- …database to ensure adequate documentation as required by regulatory agencies. + Complete concurrent review of cases to identify quality, timelines and systems of ... and Patient Safety (PIPS) Program. The PI Coordinator will review the continuum of care to determine...trauma patients. + Serve as a liaison to the clinical areas responsible for trauma patients. + Coordinate multidisciplinary… 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 . This coverage will be required twenty-four hours per… more
- Molina Healthcare (Orlando, FL)
- …expertise in the performance of prior authorization, inpatient concurrent review , discharge planning, case management and interdisciplinary care team ... + Develops medical policies and procedures + Conducts peer review **JOB QUALIFICATIONS** **REQUIRED EDUCATION:** * Doctorate Degree in...+ 10+ years relevant experience, including 5+ years of clinical practice and 3+ years HMO/Managed Care … more
- HCA Healthcare (Miami, FL)
- …**Job Summary and Qualifications** The Burn PI Coordinator performs retrospective and concurrent reviews of patient care records and assesses for specified ... auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. + Free counseling… more
- HCA Healthcare (Tallahassee, FL)
- …level of care across the continuum. Ensures plan meets patient's clinical , psychological and discharge needs in collaboration with the attending physician and ... auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. + Free counseling… more