- Molina Healthcare (St. Petersburg, FL)
- …several Pharmacy Technicians. These roles are 100% Remote and require you be licensed either State or Nationally. These positions will be Monday through Friday 10am ... those involved in formulary management (such as, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services (such… more
- ChenMed (Miami, FL)
- …experience in Hospital medicine preferred + At least one (1) year of utilization review experience preferred We're ChenMed and we're transforming healthcare for ... our team. The Physician Reviewer is the primary physician reviewer for Utilization Management/Clinical Appropriateness review cases in our organization. Other… more
- CenterWell (Tallahassee, FL)
- …hospital utilizers to identify ways to extend wellness and decrease utilization . + Ensures patient progression towards desired outcomes by monitoring symptom ... centers, patients, and other staff with suicide risk assessment review , next steps, and guidance. + Assists patients expressing...Qualifications** + Master's degree in social work (MSW) + Licensed Clinical Social Work License (LCSW) in Florida +… more
- Centene Corporation (Tallahassee, FL)
- …of utilization management processes preferred. **License/Certification:** + LPN - Licensed Practical Nurse - State Licensure required + For Health Net of ... discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in… more
- BAYADA Home Health Care (Orlando, FL)
- …+ Candidates should be available Monday-Friday from 8:30am-5:00pm. _Medicare, Coder, OASIS Review , Utilization Review , Quality Assurance, Remote, Home Health ... Home Health Care is hiring a full time OASIS Review and Coding Manager. The OASIS and Coding ...Coding_ **As an accredited, regulated, certified, and licensed home health care provider, BAYADA complies with all… more
- BAYADA Home Health Care (Orlando, FL)
- …your career with an industry leader. Apply now for immediate consideration. OASIS Review , Utilization Review , Quality Assurance, Remote, Home Health Coding, ... immediate opening for a **Full Time,** OASIS and Coding Review Manager with OASIS and Coding certification to work...Coder, Medicare **As an accredited, regulated, certified, and licensed home health care provider, BAYADA complies with all… more
- Molina Healthcare (Tampa, FL)
- …Experience Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... unrestricted State Registered Nursing (RN) license in good standing. Must be licensed for CALIFORNIA. **WORK SCHEDULE: California NON RESIDENTS must work CALIFORNIA… more
- Molina Healthcare (FL)
- …state or locality with reliable transportation. **State Specific Requirements:** IL Qualifications: Licensed within the state of Illinois or will apply for licensure ... or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina employees: If… more
- HCA Healthcare (Bradenton, FL)
- …a data-driven environment of quality and cost improvement and develops systems to review utilization of resources and objectively measure outcomes of care in ... for appeals and denials process, discharge planning, case management, and utilization review /management. + Consults with facility-level staff regarding delegated… more
- Genesis Healthcare (Oxford, FL)
- …clinical utilization , and patient identification is overseen by a licensed therapist. 20. Performs other related duties as required. Qualifications 1. Graduate ... Clinical Operations Area Director in the timely completion of the annual merit review for therapy staff. 6. Assists Clinical Operations Area Director in the hiring… more