- Evolent (Tallahassee, FL)
- …business. Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** Clinical Reviewer , Physical Therapy As a Clinical Reviewer , ... health outcomes. **Collaboration Opportunities: ** + Functions in a clinical review capacity to evaluate all cases,...that an approval cannot be rendered to the Physician Clinical Reviewer . In States where allowed, will… more
- AdventHealth (Orlando, FL)
- …Shift **The role you'll contribute:** Under general supervision of the Director of Clinical Documentation Integrity and in some situations the supervision of the ... Clinical Documentation Integrity Manager, and in collaboration with physicians,...with physicians, nursing and HIM coders, the Second Level Reviewer I strategically facilitates and obtains appropriate and quality… more
- Centers Plan for Healthy Living (Margate, FL)
- …applications for Full Time Registered Nurse without experience. The Utilization Management Clinical Reviewer works within a multidisciplinary team to help ... in their home to improve their quality of life. Utilization Management Clinical Reviewer will assess and process all authorization requests to determine medical… more
- AdventHealth (Tampa, FL)
- …Research Institute, also located at AdventHealth Tampa, leads the way in clinical and academic research in the areas of neuroscience, cardiovascular medicine, ... **The role you'll contribute:** Under general supervision of the Director of Clinical Documentation Integrity and in some situations the supervision of the … more
- HCA Healthcare (Orange Park, FL)
- …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 to $300 million in ... We are looking for a dedicated Coding Quality Audit Reviewer like you to be a part of our...result in appropriate reimbursement and data integrity. You will review outcomes are communicated to the HSC team to… 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 ... Delegated Utilization Management. **ESSENTIAL JOB DUTIES/RESPONSIBILITIES:** + Provides Delegated Clinical Appropriateness Reviews by covering the specified territories as… 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
- Catalent Pharma Solutions (St. Petersburg, FL)
- **Senior QA Technical Reviewer ** **Position Summary** Catalent, Inc. is a leading global contract development and manufacturing organization (CDMO) whose mission is ... This position is responsible for the overall Quality Assurance review of all technical documents, as they relate to...sizes to advance new medicines from early development to clinical trials and to the market. Catalent produces more… more
- Centene Corporation (Tallahassee, FL)
- …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... monitor care for behavioral health and/or substance abuse problems according to clinical information given by providers and internal criteria for medical necessity… more
- Centene Corporation (Tallahassee, FL)
- …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... monitor care for behavioral health and/or substance abuse problems according to clinical information given by providers and internal criteria for medical necessity… more