- RxBenefits (Jacksonville, FL)
- …correct and released. Job Responsibilities Include: + Operate as the central project manager for the business on new opportunity prospects, playing a pivotal role in ... schedules, channel management, B/G classifications, specialty designations, rebate eligibility, utilization trend, Utilization Management (UM) implications, Manufacturer… more
- Molina Healthcare (Jacksonville, FL)
- …candidate with a RN licensure, Diagnosis-Related Group (DRG) experience, 2 years of Utilization Review and/or Medical Claims Review experience. Knowledge in ... managed care experience in the specific programs supported by the plan such as utilization review , medical claims review , long-term services and supports… more
- Battelle Memorial Institute (Homestead AFB, FL)
- …additional clinical and administrative duties as assigned by the HP program Manager or Coordinator. **Responsibilities** + Function across the spectrum of the HP ... scope of practice + Participate in periodic meetings to review the care provided to patients to identify opportunities...+ Serve as an advisor to the HP program Manager and/or Coordinator in matters related to injury prevention,… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …+ Participate in interdisciplinary case rounds, quality improvement initiatives, and utilization review processes. + Support members during transitions of ... + Experience in a managed care, case management, or utilization review setting + Strong understanding of...or master's degree in nursing (BSN/MSN) + Certified Case Manager (CCM) or similar certification + Fluent in Spanish… more
- KBR (Tampa, FL)
- …the development and utilization of required databases. + Conduct peer (record) review s for the HP Staff as directed by governing credentialing body and local ... USSOCOM HQ and POTFF Staff, and as directed by local HP program manager and/or coordinator. + Document work performed, utilization , encounters, referrals, and… more
- Battelle Memorial Institute (Hurlburt Field, FL)
- …and provided to SOF personnel + Assist and advise the HP program Manager and/or Coordinator in matters relating to mental performance, exercise and sports psychology ... performance development, and planning + Participate in periodic meetings to review human performance training provided to patients and identify opportunities for… more
- Battelle Memorial Institute (Homestead AFB, FL)
- …effects of physical training protocols under the supervision of the HP program Manager and/or Coordinator + Coordinate training programs with HP staff to ensure a ... who are TDY/TAD or deployed under the supervision of the HP program Manager and/or Coordinator + Demonstrate and provide instruction and guidance on physical… more
- University of Miami (Miami, FL)
- … of oncology and non-oncology therapy. Responsibilities: + Collaborate with Utilization Review Department and providers to ensure clinically appropriate, ... 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) . The Reimbursement Pharmacist… more
- ChenMed (Miami, FL)
- …experience in Hospital medicine preferred + At least one (1) year of utilization review experience preferred **PAY RANGE:** $198,797 - $283,995 Salary **EMPLOYEE ... our team. The Physician Reviewer is the primary physician reviewer for Utilization Management/Clinical Appropriateness review cases in our organization. Other… more
- University of Miami (Miami, FL)
- …apply for a faculty or staff position, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The University ... of technology-enabled workflows and continuous improvement towards user adoption and utilization . IT Solutions Architect 2 - ServiceNow also understands complex… more