- Centene Corporation (Tallahassee, FL)
- …concurrent review findings + Assists with providing education to providers on utilization processes to ensure high quality appropriate care to members + ... being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member...to leadership on opportunities to improve appropriate level of care and medically necessity based on clinical … more
- AdventHealth (Altamonte Springs, FL)
- …of Utilization Management, the Physician Advisor is responsible for providing clinical review of utilization , claims management, and quality assurance ... team:** + Provides clinical support/validation for both Utilization Management and Care Management teams +...+ Provides guidance to clinical questions from Utilization Management staff involved in authorizations, concurrent review… more
- CenterWell (Jacksonville, FL)
- …patient experience, quality of care , clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify opportunities in ... determinants of health (SDOH) efforts, improving clinical outcomes and avoidable utilization + Monitor and manage daily patient care and initiatives to… more
- CenterWell (Daytona Beach, FL)
- …experience, quality of care , clinical outcomes, and avoidable utilization *Periodically review clinician charts to identify opportunities in care ... determinants of health (SDOH) efforts, improving clinical outcomes and avoidable utilization *Monitor and manage daily patient care and initiatives to… more
- University of Miami (Miami, FL)
- …Miami, Bascom Palmer Eye Institute, has an exciting job opportunity for a full time Clinical Program Coordinator - Virtual Eye Care in Miami, Florida. The ... updates to the Health System provider directory. + Assists clinical research coordinators as needed to facilitate care...Care Teams in the EMR. + Promotes patient utilization and understanding of the EMR patient portal for… more
- Evolent (Tallahassee, FL)
- …you ready to make a meaningful impact on patient care in a non- clinical setting? Join our Utilization Management team as a Field Medical Director, ... when available, within the regulatory timeframe of the request. + Utilizes medical/ clinical review guidelines and parameters to assure consistency in the… more
- AdventHealth (Orlando, FL)
- …+ Clinical Pharmacy Services Actively participates in direct patient care programs and provides accurate, safe, timely, and appropriate medication therapy based ... 80 new private rooms designed to enhance the holistic care experience + Annual number of emergency cases: 89,018...of emergency cases: 89,018 **The role you'll contribute:** The Clinical Pharmacist supports the mission of the department, hospital,… more
- AdventHealth (Orlando, FL)
- …+ Clinical Pharmacy Services Actively participates in direct patient care programs and provides accurate, safe, timely, and appropriate medication therapy based ... and 125,000 outpatients each year **The role you'll contribute:** The Clinical Pharmacist supports the mission of the department, hospital, and health-system… more
- CenterWell (Clearwater, FL)
- … of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and conducts ... and help us put health first** + The **RN Clinical Manager** coordinates and oversees all direct care...requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking… more
- Molina Healthcare (St. Petersburg, FL)
- …Experience** Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / ... team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care , for… more