- BayCare Health System (Tampa, FL)
- …built on a foundation of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior responsibilities include:** ... Community discounts and more Equal Opportunity Employer Veterans/Disabled **Position** Utilization Review Specialist Sr. **Location** Tampa:St Josephs | Clinical … more
- CVS Health (Tallahassee, FL)
- …with medical director teams focusing on inpatient care management, clinical coverage review , member appeals clinical review , medical claim review , ... Be present for regulatory audits in-person. * Support all Clinical Quality initiatives and peer review processes including Quality of Care and Quality of Service… more
- AdventHealth (Altamonte Springs, FL)
- …support of Utilization Management, the Physician Advisor is responsible for providing clinical review of utilization, claims management, and quality assurance ... staff, as well as collaborating with other disciplines to assist in the improvement of clinical documentation, patient safety, and quality outcomes. Through primary… 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 ... make a meaningful impact on patient care in a non- clinical setting? Join our Utilization Management team as a...MD review process to reflect appropriate utilization and compliance with… 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 ... the culture. **What You'll Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management, you will be a...MD review process to reflect appropriate utilization and compliance 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 process to reflect appropriate utilization and compliance 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 process to reflect appropriate utilization and compliance with… more
- CVS Health (Tallahassee, FL)
- …+ **Accountable clinical quality monitoring and oversight at the regional level** + Chart Review + Clinical Quality Review + Clinical Quality Support ... excellence through demonstration of quality and safety competencies in clinical practice, chart review and clinical...and safety competencies in clinical practice, chart review and clinical coaching. **PREFERRED QUALIFICATIONS:** +… 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 process to reflect appropriate utilization and compliance with… 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 ... to make a difference in patients lives, in a non- clinical environment. You can enjoy better work- life balance...MD review process to reflect appropriate utilization and compliance with… more