- Elevance Health (Miami, FL)
- …+ Demonstrate and maintain knowledge of relevant policies and regulations pertaining to utilization review of oncology care. + Participate on committees or in ... and providers. **How you will make an impact:** + Perform physician-level case review , following initial nurse review , of Medical Oncology regimens and… more
- General Dynamics Information Technology (Eglin AFB, FL)
- …consistent, appropriate, and required documentation. + If directed by HP program Manager and/or Coordinator, directly supervise the PT Tech, PT Assistant, and/or ... + Serve as an advisor to the HP program Manager and/or Coordinator in matters related to injury prevention,...of care. + Provide input for the development and utilization of required databases. + Conduct peer (record) reviews… more
- HCA Healthcare (Ocala, FL)
- …as assigned by Manager /Director. + First line resource to Case Managers, Utilization Review , and Medical Social Workers. Elevates issues as appropriate. + ... monitoring of caseload for Case Manages based on appropriate level of care, utilization of services and plan of care. Ensures equitable caseload assignments. +… more
- HCA Healthcare (Kissimmee, FL)
- …of Physician Services II with HCA Florida Osceola Hospital, you can be a manager in an organization that is devoted to giving! **Benefits** HCA Florida Osceola ... as patient flow, patient satisfaction, practice volume, billing and collections, service utilization , coding, physician and staff training + You will have strategic… more
- General Dynamics Information Technology (Hurlburt Field, FL)
- …scope of the PD position description, as assigned by the HP program Manager and/or Coordinator. + Documents work performed, utilization , encounters, referrals, ... guidelines for rehabilitation and performance. + Collaborates with the HP program Manager and/or Coordinator for implementation of new protocols and guidelines. +… more
- Elevance Health (Miami, FL)
- …or equivalent. Requires a minimum of 4 years of clinical experience and/or utilization review experience. Current active, valid and unrestricted LPN/LVN license ... improvement initiatives to improve the efficiency and effectiveness of the utilization reviews within the medical management processes. + Assesses and applies… more
- Elevance Health (Tampa, FL)
- …regarding case and determines appropriate area to refer or assign case ( utilization management, case management, QI, Med Review ). Provides information regarding ... reports and documents all actions. + Responsibilities exclude conducting any utilization management review activities which require interpretation of clinical… more
- CenterWell (Daytona Beach, FL)
- …in patient experience, quality of care, clinical outcomes, and avoidable utilization *Periodically review clinician charts to identify opportunities in ... social determinants of health (SDOH) efforts, improving clinical outcomes and avoidable utilization *Monitor and manage daily patient care and initiatives to improve… more
- Elevance Health (FL)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... clinical case reviews with attending physicians or other ordering providers to discuss review determinations. + Serves as a resource and consultant to other areas of… more
- CenterWell (Jacksonville, FL)
- …performance in patient experience, quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify opportunities ... of health (SDOH) efforts, improving clinical outcomes and avoidable utilization + Monitor and manage daily patient care and...and monitor clinical & financial performance and metrics. + Review clinician schedules and incentive plans to align with… more
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