- Community Health Systems (Naples, FL)
- **Job Summary** Under the direction of the UR Director/Manager the UR Nurse reviews all admissions for medical necessity, correct orders based on medical condition ... improvement programs + Addresses facility and departmental communication through daily review of all correspondence, including incoming email messages. + Performs… more
- MyFlorida (Santa Rosa Beach, FL)
- LICENSED PRACTICAL NURSE - 64084879 Date: Jul 29, 2025 The...the end of the clinic visit. + Performs Chart Review as directed for QA/QI. + Documents lab work ... 857660 Agency: Department of Health Working Title: LICENSED PRACTICAL NURSE - 64084879 Pay Plan: Career Service Position Number:...Documents DAP medication pick up in HMS. + Completes HEDIS /UDS measure tool for clients prior to each visit.… more
- CenterWell (Plant City, FL)
- …part of our caring community and help us put health first** The Nurse Practitioner applies advanced education and clinical competencies to achieve optimal patient ... outcomes. The Nurse Practitioner works on problems of diverse scope and...leadership. + Meets with RMD about quality of care, review of outcome data, policy, procedure and records issues.… more
- Centene Corporation (Spring Hill, FL)
- …field or equivalent work experience within a managed care environment related to HEDIS record review , quality improvement, medical coding or transferable skill ... or related field. **Candidate Experience:** Required: 1+ year of experience in related HEDIS medical record review or quality improvement with experience in data… more
- University of Miami (Miami, FL)
- …preferred + Completion of Medicare annual wellness exam documentation preferred + Knowledge of HEDIS Quality Care Gaps - review and closure preferred + Knowledge ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . APP, Supervisor -… more
- CenterWell (Tallahassee, FL)
- …as possible. **Responsibilities:** . Act as a collaborating physician for nurse practitioners or physician assistants, including completing regular chart review ... . Meet with clinic leaders about quality of care, review of outcome data, policy, procedure, and records issues....Knowledge of Medicare guidelines and coverage . Knowledge of HEDIS quality indicators . Experience working in value-based care… more
- Molina Healthcare (Orlando, FL)
- …the Chief Medical Officer. + Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the ... Public Health, Healthcare Administration, etc. **PREFERRED EXPERIENCE:** + Peer Review , medical policy/procedure development, provider contracting experience. + Experience… more
- MyFlorida (St. Petersburg, FL)
- …in all aspects of their work. The OPS Advanced Practice Registered Nurse Specialist is responsible for providing comprehensive health care to clients, including ... + Participate in quality assurance activities including meetings and peer review . + Ensure cooperation and coordination between Clinical Services Division, Disease… more