- Evolent (Tallahassee, FL)
- …mission. Join a mission with a company behind it. **What You'll Be Doing:** As a Clinical Reviewer , Nurse, you will be a key member of the utilization management ... while providing better health outcomes. **Collaboration Opportunities:** As a Clinical Reviewer , Nurse, you will routinely interact...**What You Will Be Doing:** + Functions in a clinical review capacity to evaluate all cases,… 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
- HCA Healthcare (Jacksonville, FL)
- …Do you want to join an organization that invests in you as a Coding Quality Audit Reviewer ? At Parallon, you come first. HCA Healthcare has committed up ... the course of three years. **This position is fully remote /work from home!** **Schedule: Monday-Friday Day Shift** **Must have...a difference. We are looking for a dedicated Coding Quality Audit Reviewer like you to be… more
- AdventHealth (Orlando, FL)
- …Second Level Reviewer I strategically facilitates and obtains appropriate and quality physician documentation for any clinical conditions or procedures to ... completeness and accuracy for severity of illness (SOI), risk of mortality (ROM), and quality . + Completes accurate and timely record review to ensure the… 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
- Prime Therapeutics (Tallahassee, FL)
- …that meet clinical review criteria. Refers all cases not meeting clinical criteria to pharmacist clinical reviewer . + Practices and maintains the ... drives every decision we make. **Job Posting Title** Initial Review Pharmacy Technician - Remote **Job Description**...requests to nurse, pharmacist or physician on the utilization review clinical team when further review… more
- Prime Therapeutics (Tallahassee, FL)
- …fuels our passion and drives every decision we make. **Job Posting Title** Clinical Account Executive Supporting Florida Client - Remote **Job Description** ... role will support a Florida Client - open to remote with preferred candidate to reside in Florida and...clinical products, clinical initiatives, participation in clinical meetings, continuous quality improvement execution and… more
- Prime Therapeutics (Tallahassee, FL)
- …our passion and drives every decision we make. **Job Posting Title** Policy Clinical Pharmacist- REMOTE **Job Description** Creates new and updates existing ... not limited to, responding to inquiries, customization of policies, Client policy review , education, QBR support, clinical meetings, audit assistance, special… more
- Prime Therapeutics (Tallahassee, FL)
- …our passion and drives every decision we make. **Job Posting Title** Clinical Pharmacist (Algo), Professional-Senior- REMOTE **Job Description** Maintains the ... projects as determined by business needs. + Collaborating with Clinical Operations, IT, Quality , and Compliance as...collaborate and work well as a team. + Data review and interpretation skills required. **Preferred Qualifications** + Managed… more
- AdventHealth (Altamonte Springs, FL)
- …Clinical Documentation Specialist (CDS) strategically facilitates and obtainsappropriate and quality physician documentation for any clinical conditions or ... completeness and accuracy for severity of illness (SOI), risk of mortality (ROM) and quality . . Completes accurate and timely record review to ensure the… more