- 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
- Zelis (St. Petersburg, 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
- Catalent Pharma Solutions (St. Petersburg, FL)
- …Technical Reviewer ** **Position Summary** This position is responsible for the overall Quality Assurance review of all technical documents, as they relate to ... challenges. Catalent is committed to a Patient First culture through excellence in quality and compliance, and to the safety of every patient, consumer and Catalent… more
- AdventHealth (Altamonte Springs, FL)
- …elected leaders to ensure an effective peer review , credentialing, and quality assurance process. + Support clinical outcomes reporting, research compliance ... efforts to bolster performance improvement, mitigate risks, ensure safety, uphold clinical quality standards, facilitate continuing medical education, oversee… more
- CenterWell (Jacksonville, FL)
- … clinical performance in patient experience, quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts to ... hire, and supervise clinical teams to staff and develop a high- quality clinical team with strong engagement, patient-first culture, and talent retention… more
- University of Miami (Miami, FL)
- … team to perform daily duties (supplies, medications, vaccines). + Support clinical quality initiatives (eg Diabetes management, preventive screenings). + ... and departmental expansion. + Assists with the development/revision and review of clinical policies and procedures. +...+ Works effectively and cooperatively in groups/teams to ensure quality patient care. + Review monthly Qualtrics… more
- CenterWell (Daytona Beach, FL)
- … clinical performance in patient experience, quality of care, clinical outcomes, and avoidable utilization *Periodically review clinician charts to ... hire, and supervise clinical teams to staff and develop a high- quality clinical team with strong engagement, patient-first culture, and talent retention… more
- Highmark Health (Tallahassee, FL)
- …**Job Description :** **JOB SUMMARY** This job works collaboratively riskacross Highmark Health clinical areas to support clinical quality auditing, The ... policies, state, CMS, and federal regulations. This role serves as a clinical subject matter expert, providing insights and guidance to internal departments. The… more
- Banner Health (FL)
- …documentation completed by the health care team for the health record(s) and for quality assurance in the alignment of clinical documentation and billing codes. ... Works with clinical documentation improvement and quality management staff to: align diagnosis coding to documentation to improve the quality of clinical … more
- CenterWell (Daytona Beach, FL)
- …and complaints from patients + Ongoing chart review / audit of clinical staff to ensure quality care and identifying opportunities for education/coaching + ... clinical protocols / disease prevalence / appropriate levels of clinical quality care + Providing guidance to individual clinicians about patient… more