- AdventHealth (Maitland, FL)
- …site) **Job Location** : Maitland, FL **The role you will contribute:** A Medical Economics Manager is responsible for overseeing the analysis and evaluation of ... methodology, data tools, modeling, managing revenue, and managing and mentoring of director reports. Must be able to complete extensive and complex financial,… more
- ChenMed (Pembroke Pines, FL)
- …departments, and other healthcare facilities. + In conjunction with the PCP, hospitalist, Medical Director of Transitional Care, insurance case manager and the ... engagement with patient and family. + Facilitate patient/family conferences to review treatment goals, optimize resource utilization , provide family education… more
- Elevance Health (Miami, FL)
- …nursing judgment to determine whether treatment is medically necessary and provides consultation to Medical Director on cases that are unclear or do not satisfy ... not in line with diagnosis. + Provide consultation to Medical Director on particularly peculiar or complex...experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or… more
- Fresenius Medical Center (Venice, FL)
- …+ Facilitates the application process for physician privileges and compliance with FMS Medical Staff By-Laws. + Responsible for strong Director and physician ... communicated to and implemented by the facility staff. + Maintains integrity of medical records and other FMS administrative and operational records. + Complies with… more
- CenterWell (The Villages, FL)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... delivery, and documentation requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance … more
- Fresenius Medical Center (Tampa, FL)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. ... advance your career into an Area Team Lead or Director of Operations role. **Our culture:** We believe our...a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in… 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 ... for the requested level of care/patient status to the Medical Director . + Proactively identifies and resolves...+ Experience in a managed care, case management, or utilization review setting + Strong understanding of… more
- Carnival Cruise Line (Miami, FL)
- …The Manager also escalates high-risk cases, conducts care coordination and utilization reviews. Operationally, the role supports shipboard medical teams, ... for duty per International Maritime Health guidelines. + **Crew Medical Claims Management** + Review crew cases...+ Lead investigations into complaints or concerns regarding crew medical issues. + Conduct utilization reviews to… more
- University of Miami (Miami, FL)
- …overall success. + Serves as a liaison between the Program Director (s), administrative leadership, UM/JMH Graduate Medical Education (GME) administration, ... 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 Department of… more
- HCA Healthcare (Kissimmee, FL)
- …and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low ... as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision...products for patient administration. The buyer works with the director and clinical team to ensure formulary compliance and… more