- AdventHealth (Altamonte Springs, FL)
- …assists in drafting and submitting clinical denial appeals, as needed + Develops Medical Director relationships with payors to have open communication and ... will contribute:** The Physician Advisor provides primary support for Utilization Management ( UM ) and secondary support for...Management (CM) departments and serves as a liaison between UM and CM teams and medical staff,… more
- AdventHealth (Tampa, FL)
- …role you'll contribute** **:** The Physician Advisor provides primary support for Utilization Management ( UM ) and secondary support for Care Management (CM) ... departments and serves as a liaison between UM and CM teams and medical staff,...teams Provides education and serves as a resource to Medical Staff colleagues regarding best practices, Utilization … more
- Evolent (Tallahassee, FL)
- …LCSW, and LPCs, Clinical Reviewers. Opportunities to work collaboratively with other Utilization Management Leaders including our Director may also be available. ... the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management** at Evolent will serve as a point...also works with our clinical team, which includes our medical reviews: LVNs, LPNs, and RNs along with our… more
- Veterans Affairs, Veterans Health Administration (Orlando, FL)
- …Verification, Veteran Services, Compliance, Providers, Health Information Management (HIM), Utilization Management ( UM ), and Community Care. Completes 4-6 ... Nurse Manager is accountable to the Consolidated Patient Account Center (CPAC) Director , manages RUR Assistant Nurse Managers, RUR Nurses, and general schedule (GS)… more
- Molina Healthcare (St. Petersburg, FL)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... at the most effective setting. Evaluates the effectiveness of UM practices. Actively monitors for over and under- utilization...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- CVS Health (Tallahassee, FL)
- …resistant illnesses through peer review and educational interventions. * Work with medical director teams focusing on inpatient care management, clinical ... outcomes. * Leverage extensive knowledge of health care delivery system, utilization management, reimbursement methods and treatment protocols for DSNP/MMP and other… more
- CVS Health (Tallahassee, FL)
- …do it all with heart, each and every day. **Position Summary:** Ready to take your Medical Director skills to the next level with a Fortune 6 company? Checkout ... Jersey, New York, Ohio, Oklahoma, Pennsylvania, Texas, Virginia and West Virginia. This Medical Director will be a "Work from Home" position primarily supporting… more
- ChenMed (Margate, FL)
- …We're rapidly expanding and we need great people to join our team. The Medical Director , Center is specifically responsible for executing the ChenMed Way and ... core model in his/her assigned center. Under the direction of the Market Chief Medical Officer (MCMO), the Medical Director , Center will directly supervise,… more
- University of Miami (Miami, FL)
- …logistical knowledge of organ donation/recovery process in a timely manner. + Keeps UM LAORA Clinical Operations Director and Organ Allocation and Recovery ... responsible for all activities related to the allocation and utilization of organs from donors. Including, organ allocation for...of recovered organs when necessary. + Familiar with all medical aspects of organ donation and bring any questions… more
- AdventHealth (Orlando, FL)
- …relationships and share observations and provider improvement opportunities. Collaborates with Medical Director (s) to review and provide insight regarding ... teams. Provides education and serves as a resource to Medical Staff colleagues regarding best practices, Utilization ...concurrent review, and denials as a back up to UM Physician Advisory as and when needed. Assists with… more