- Elevance Health (Miami, FL)
- **Nurse Reviewer I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ... **with rotating weekends.** **New Grads are encouraged to apply!** The **Nurse Reviewer I** will be responsible for conducting preauthorization, out of network and… more
- ChenMed (Miami, FL)
- …to join our team. The Physician Reviewer is the primary physician reviewer for Utilization Management/ Clinical Appropriateness review cases in our ... for our patients. The position will also participate in Process and Quality improvement in our developing area of Delegated Utilization Management. **ESSENTIAL JOB… more
- University of Miami (Miami, FL)
- … Clinical Research Nurse 2 position. The incumbent ensures the integrity and quality of clinical research studies are maintained and conducted in accordance ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Diabetes Research… more
- Zelis (FL)
- …found and justifying the revised choices of new codes and DRG, based on the clinical evidence obtained during the review + Document all aspect of audits ... interests that shape who you are. Position Overview The Inpatient DRG Reviewer will be primarily responsible for conducting post-service, pre-payment and post pay… more
- University of Miami (Miami, FL)
- …FL CORE SUMMARY The Clinical Research Nurse 1 ensures the integrity and quality of clinical research studies are maintained and conducted in accordance with ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The University of… more
- University of Miami (Plantation, FL)
- …CORE JOB SUMMARYThe Clinical Research Nurse 1 ensures the integrity and quality of clinical research studies are maintained and conducted in accordance with ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The University of… more
- University of Miami (Miami, FL)
- …Fl. CORE SUMMARY The Clinical Research Nurse 1 ensures the integrity and quality of clinical research studies are maintained and conducted in accordance with ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The University of… more
- CVS Health (Tallahassee, FL)
- …coordination, and strategic reporting to align local efforts with state and national quality goals. **Key Responsibilities** ** Clinical Review & Compliance** ... clinical expertise with quality improvement leadership, including clinical documentation review , Performance Improvement Projects (PIPs), ANE oversight,… more
- Evolent (Tallahassee, FL)
- …utilization management with collaborative engagement and innovation. **Core Responsibilities** + ** Clinical Review & Peer Collaboration** + Serve as the ... obtain). + Demonstrated **leadership in practice transformation, value-based care, or clinical quality improvement** . + Strong communication, collaboration, and… more
- CVS Health (Tallahassee, FL)
- …specified for the plan. Be present for regulatory audits in-person. * Support all Clinical Quality initiatives and peer review processes including Quality ... and other complex health populations to optimize risk adjustment, clinical quality , and care management. * Actively...focusing on inpatient care management, clinical coverage review , member appeals clinical review ,… more