- Molina Healthcare (Miami, FL)
- …as well as minimum over read standards. **Job Duties** + Coordinates the HEDIS medical record review which includes ongoing review of records submitted ... by providers and the annual HEDIS medical record review . + Participates in meetings with vendors for the medical record collection process. + As needed, may… more
- HCA Healthcare (Port Charlotte, FL)
- …your career path, we encourage you to apply for our Charge Nurse CNC Medical Oncology opening. We review all applications. Qualified candidates will be contacted ... **Description** **Introduction** Do you have the career opportunities as a Charge Nurse CNC Medical Oncology you want in your current role? We invest in what matters… more
- Elevance Health (Miami, FL)
- …and medical records to either approve or summarize and route to nursing and/or medical staff for review . + The grievance and appeal work is subject to ... to convey the determination. + Responsibilities exclude conducting any utilization or medical management review activities which require the interpretation of… more
- University of Miami (North Miami, FL)
- …Clinical knowledge and experience in hospital and other healthcare settings, including medical record review and analysis, with documented experience and ... 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
- Sedgwick (Orlando, FL)
- …clinical review of referred claims; documents decision rationale; and completes medical review of all claims to ensure information substantiates disability. ... consult providers and employees; to provide case direction; and to ensure medical information substantiates the need for absence from work. **ESSENTIAL FUNCTIONS and… more
- Carnival Cruise Line (Miami, FL)
- …team to assess fitness for duty per International Maritime Health guidelines. + **Crew Medical Claims Management** + Review crew cases of high risk and escalate ... care coordination and utilization reviews. Operationally, the role supports shipboard medical teams, participates in the 24/7 duty rotation, and manages ship… more
- CVS Health (Tallahassee, FL)
- …referral from medical services staff. - Approve services that do not require a medical review in accordance with the benefit plan. - Performs non- medical ... every day. + **Position Summary** :- Supports comprehensive coordination of medical services including intake, screening, and referrals. - Promotes/supports quality… more
- ChenMed (Miami, FL)
- …on a quarterly basis (or as mandated by law) for onsite observation and medical record review by the respective delegating physician. + If supporting patients ... a bi-annual (or as mandated by law) basis for onsite observation and medical record review by the respective delegating physician. + Required to adhere to any… more
- Wellpath (Gainesville, FL)
- …and assisting with civil commitments when necessary. Psychiatrists also participate in medical review committees and deliver consultations to facility staff. ... * Growth and training **Perks and Benefits** In addition to comprehensive benefits including medical , dental, vision, paid time off, and 401k, we foster a work, life… more
- Cleveland Clinic (Stuart, FL)
- …and procedures, obtain feedback and provide open communication within the team. + Review and order necessary office and/or medical supplies. + Facilitate the ... serving as a liaison between patients, Central Appointments and/or other medical departments. + Review the Expert Notify list daily and the Open Encounter report… more