- Highmark Health (Tallahassee, FL)
- …efficiency strategies, contractual or programmatic changes, quality-of-care outcomes, customer service and other specific product related requirements. The incumbent ... insight for capitated rate negotiations and internal financial forecasting. + Provide clinical expertise, and serve as an influential member of internal clinical… more
- MTC (Panama City, FL)
- …to a healthy, productive life. **Position Summary:** Responsible for providing medical services related to diagnosis and treatment of inmates and emergency treatment ... + Performs complete medical histories and physical examinations; forms clinical impressions based upon findings; orders, diagnostic tests, interprets results… more
- Molina Healthcare (Jacksonville, FL)
- …medical oversight and expertise in appropriateness and medical necessity of services provided to members, targeting improvements in efficiency and satisfaction for ... Job Duties * Determines appropriateness and medical necessity of health care services provided to plan members. * Supports plan utilization management program and… more
- Highmark Health (Tallahassee, FL)
- …are performed in accordance with the highest and most current clinical standards. The incumbent reviews escalated cases electronically and using Medical ... to evaluate the medical necessity and appropriateness of the requested treatment of service . Depending on the nature of the case, telephonic peer to peer discussions… more
- Ascension Health (Panama City, FL)
- … clinical activities, including patient assessment, care plan development, service level determination, patient visits, and complaint management. + Prepare and ... staff are utilized efficiently and resourcefully. + Remove obstacles to achieving clinical quality, service excellence and financial effectiveness targets. +… more
- AdventHealth (Orlando, FL)
- …join a multidisciplinary team with a large established patient population base to service . Physician can expect the ability to participate in research studies, and ... with our cardiology fellows. The role will be 0.6 FTE clinical and 0.4 FTE administrative. Non-Invasive Cardiologists, Invasive Non-Interventional Cardiologists,… more
- Bristol Myers Squibb (Tampa, FL)
- …in our work environment. We offer a wide variety of competitive benefits, services and programs that provide our employees with the resources to pursue their ... Reporting, you will leverage your extensive knowledge to guide the People Services team towards a more customer-centric approach to people-related transactions and… more
- HCA Healthcare (Jacksonville, FL)
- …ACGME requirements: + Have at least three (3) years of prior and relevant clinical activity in practice + At least three (3) years of prior GME administrative ... review articles, peer-reviewed journals, textbook chapters, case reports or clinical series presentations at scientific society meetings, and participation in… more
- WestCare Foundation (Pinellas County, FL)
- …community as requested by the Outpatient Program Manager and/or OP Services Director + Assist in developing clinical staff work schedules and assign daily ... and record-keeping. + Provide feedback to the Outpatient Program Manager and/or Outpatient Services Director and staff regularly. + Embrace and embody the… more
- Highmark Health (Tallahassee, FL)
- …payers. Programs will include but not be limited to fee for service , pay-for-value programs, episode payments, prospective bundled payments, gain share and risk ... as a subject matter expert working in concert with provider relations and clinical transformation consultants to explain new programs and results to key provider… more