- ChenMed (Bradenton, FL)
- …compliance with guidelines. This position may require participation in risk and quality management programs, clinical meetings and other meetings. The Nurse ... to join our team. The Nurse Practitioner (NP) acts as part of the clinical operations team and is responsible for providing direct patient care in ChenMed/Jencare… more
- Veterans Affairs, Veterans Health Administration (Miami, FL)
- …PACT phone calls, collaboration, case management, paperwork, etc. Responsible for the clinical performance measures on quality and access Adheres to the ... the Primary Care Provider will be assigned to perform chart review for Quality Improvement. Will supervise medical students, residents and/or fellows Work… more
- CVS Health (Tallahassee, FL)
- …features using React Native and Swift for our clinical applications + _Code Review & Quality Assurance_ - Participate in code review processes to ... with product managers, designers, and other engineering teams to deliver high- quality solutions + _Technical Documentation -_ Contribute to technical documentation… more
- Evolent (Tallahassee, FL)
- …provides clinical rationale for standard and expedited appeals. . Utilizes medical/ clinical review guidelines and parameters to assure consistency in the MD ... to make a difference in patients lives, in a non- clinical environment. You can enjoy better work- life balance...Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines. . Aids and acts as… more
- Evolent (Tallahassee, FL)
- …provides clinical rationale for standard and expedited appeals. + Utilizes medical/ clinical review guidelines and parameters to assure consistency in the MD ... to make a difference in patients lives, in a non- clinical environment. You can enjoy better work- life balance...Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines. + Aids and acts as… more
- AdventHealth (Maitland, FL)
- …providing a wide range of general medical management services to improve clinical cost, utilization, coding, documentation, quality , and member service ... management services. **The value you'll bring to the team:** + Communicates clinical cost, utilization, appropriate coding and documentation, quality , and member… more
- Evolent (Tallahassee, FL)
- …when available, within the regulatory timeframe of the request. + Utilizes medical/ clinical review guidelines and parameters to assure consistency in the ... Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines. + Ensures documentation of all communications with… more
- Evolent (Tallahassee, FL)
- …Provides clinical rationale for standard and expedited appeals. + Utilizes medical/ clinical review guidelines and parameters to assure consistency in the MD ... to make a difference in patients' lives, in a non- clinical environment. You can enjoy better work- life balance...Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines. + Aids and acts as… more
- Veterans Affairs, Veterans Health Administration (Miami, FL)
- …This schedule is subject to change based on Managerial discretion. Responsible for the clinical performance measures on quality and access Adheres to the service ... improving utilization of resources and suggesting process changes for clinical programs in the Primary Care Section. NOTE: The...aware and accountable to the fiscal measures and utilization review Pay: Based on approved pay rates per task… more
- AdventHealth (Daytona Beach, FL)
- …to allow for accurate public reporting of clinical outcomes. Utilizes clinical expertise to review patient care episodes across the continuum and ... variability to provide opportunities for continuous performance improvement. Coordinates Institute Quality and Outcomes committees or clinical projects across… more