- University of Miami (Miami, FL)
- …or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The ... hospital personnel. CORE JOB FUNCTIONS 1. Oversees patient flow through designated clinical areas. 2. Maintains nursing guidelines by writing and updating policies… more
- Sharecare (Tallahassee, FL)
- …+ Prepare, in collaboration with Director Client Success the QBR and Annual Review **Reporting** + Collaborate with the reporting team to analyze necessary data, ... develop reports and dashboards and deliver monthly, quarterly and annually + Review and analyze reports for accuracy and outcomes needed to satisfy the client +… more
- Datavant (Tallahassee, FL)
- …the pharmaceutical and life sciences space + Understanding of drug development and/or clinical trials \#LI-BC1 We are committed to building a diverse team of ... protected status. To learn more about our commitment, please review our EEO Commitment Statement here (https://www.datavant.com/eeo-commitment-statement) . Know Your… more
- US Tech Solutions (Miami, FL)
- …healthcare costs and improve healthcare program/operational efficiency involving clinical issues + Determines medical necessity/ appropriateness Facilitates optimal ... comprehensive evaluation of Members using care management tools and information/data review + Coordinates and implements assigned care plan activities and monitors… more
- CVS Health (Tallahassee, FL)
- …and follow up activity as needed, and manages regulatory complaint review and audit activities. + Independently manages multiple complex regulatory interactions, ... Familiarity with provider directory requirements and laws + Experience with clinical operations - utilization management, case management, disease management. +… more
- CVS Health (Miami, FL)
- …inform members about available benefits and services. + **Reporting & Analytics:** Review and interpret data related to claims, utilization, and service issues. ... Escalation & Follow-up:** Collaborate cross-functionally with internal teams (Eligibility, Claims, Clinical ) to track and resolve complex or repeated issues and… more
- University of Miami (Miami, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Location: ... Sign-on Bonus: $25,000 CORE JOB FUNCTIONS Oversees patient flow through designated clinical areas. Maintains nursing guidelines by writing and updating policies and… more
- Cleveland Clinic (Vero Beach, FL)
- …through the American Heart Association (AHA) + 3-5 years of recent RN clinical experience + Working knowledge of MCG guidelines Preferred qualifications for the ... (CTM, ACM, CCM or AHA) + 2 years of recent experience in utilization review , quality or care management + Knowledge of acute care and accreditation requirements +… more
- Veterans Affairs, Veterans Health Administration (Lake City, FL)
- …Health Clinic Program Manager : The Lake City Mental Health Clinic Program Manager is responsible and accountable for all clinical and administrative Mental ... the credentialing and privileging processes, monitoring and evaluation of clinical practice, peer review , and other appropriate...Services in policy development and program planning. The Program Manager will also function in a clinical … more
- Trinity Health (Fort Lauderdale, FL)
- …complete documentation to ensure revenue optimization and integrity. Perform outpatient clinical documentation improvement review (acute only) as needed. Perform ... charge reviews; including but not limited to, appending modifiers and checking clinical documentation. Works closely with Revenue Integrity staff and providers to… more