- Cleveland Clinic (Weston, FL)
- …has been committed to the improvements in patient care, enhancements in medical education and breakthroughs in medical research. Continuing the world-renowned ... Clinic, Cleveland Clinic Florida physicians excel at the diagnosis and treatment of medical problems that are complex or difficult to treat. Cleveland Clinic Weston… more
- CVS Health (Tallahassee, FL)
- …program/operational efficiency involving clinical issues. Supports comprehensive coordination of medical services including intake, screening and referrals to Aetna ... Medical Services Programs. Promotes/supports quality effectiveness of Healthcare Services...and local laws. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting,… more
- MyFlorida (Tallahassee, FL)
- …contracts and departmental procedures. Tracks Workers' Compensation claims and Extended Medical Leave for the North Region Detention Services. Works with ... Keeps accurate, up-to-date log of all Workers' Compensation injuries and Extended Medical Leave cases in the North Region Detention Services. Logs are updated… more
- CVS Health (Tallahassee, FL)
- …Summary** The Negotiator Analyst is responsible for negotiating out-of-network (OON) medical claims valued at $10,000 and above. This role involves learning ... role, and understanding (U&C) calculated rates and benchmarking of medical costs. The individual will be developing their role...and local laws. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting,… more
- CVS Health (Tallahassee, FL)
- …Summary** + Responsible for performing second level quality inter-rater review audits of medical records coded by internal team, as well as external vendor (if ... guidelines and regulations to meet compliance requirements, such as establishing medical necessity. + Identify and communicate documentation deficiencies to allow… more
- Humana (Miramar, FL)
- …Screen physician's orders and documentation to identify that all qualifying medical documentation and required information is included. When necessary, request ... Plan contract. Review referral data matching it against specified medical terms and diagnoses or procedure codes and follow...It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the… more
- CVS Health (Miami, FL)
- …services. + Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care to facilitate the ... member/client's appropriate condition management to optimize wellness and medical outcomes, aid timely return to work or optimal...and local laws. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting,… more
- CVS Health (Tallahassee, FL)
- …within time zone of residence.** American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health. Founded in 1993, ... Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support cost-effective quality care for members.… more
- Cardinal Health (Tallahassee, FL)
- …to Cardinal Health_** Analytics & Innovation, with a focus on Medical Chargebacks, is responsible for planning, developing, communicating, implementation, and ... project goals + Gain an understanding of how the Medical Chargebacks processes works at a high level and...processes works at a high level and the challenges Medical Chargebacks face to help us imagine valuable solutions… more
- Florida Atlantic University (FL)
- …Associate Professor. The mission of the Schmidt College of Medicine as a community-based medical school is to advance the health and well-being of our community by ... programs, in partnership with our hospital partners, that enable our medical students and residents to become active, self-directed, life-long learners; equip… more