- Evolent (Tallahassee, FL)
- …and provides clinical rationale for standard and expedited appeals. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... the culture. **What You'll Be Doing:** As a Field Medical Director, Physical Medicine and Rehab you will be...and management staff, other Physicians, and staff whenever a physician `s input is needed or required. **What You Will… more
- Veterans Affairs, Veterans Health Administration (Tampa, FL)
- …comprehensive review of the patient health record to abstract medical , surgical, ancillary, demographic, social, and administrative data to ensure complete data ... Information Management (HIM) section at the James Haley VA Medical Center. MRTs (Coder) are skilled in classifying ...from patient health records in the hospital setting, and/or physician -based settings, such as physician offices, group… more
- Elevance Health (Tampa, FL)
- …clinical case reviews for their board certified specialty. + Makes physician to physician calls to gather medical appropriate information in order to make ... decisions. + Brings to their supervisors attention, any case review decisions that require Medical Director ...attention, any case review decisions that require Medical Director review or policy interpretation. **Mimimum… more
- Evolent (Tallahassee, FL)
- …and provides clinical rationale for standard and expedited appeals. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... and management staff, other Physicians, and staff whenever a physician `s input is needed or required. What You Will...imaging cases, that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests… more
- Elevance Health (Tampa, FL)
- … medical necessity of requests using clinical criteria. + Performs physician -level case review of musculoskeletal utilization requests. + Conducts ... **Clinical Operations Associate Medical Director** **Orthopedic Spine Surgery** **Carelon Medical...peer-to-peer consultation with ordering physicians, physician assistants and advanced practice nurses regarding established guidelines… more
- Northwell Health (West Palm Beach, FL)
- …preparation by ensuring required lab results and documentation are available in the medical record for practitioner review (for practices using paper medical ... **Req Number** 162599 Job Description Performs patient care under the physician 's/nurse's direct supervision. Duties include preparing patient for physician ,… more
- University of Miami (Miami, FL)
- …order to achieve maximum operational effectiveness and customer satisfaction. + Ensure that medical physician availability is provided to render care to these ... 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 Medical… more
- University of Miami (Miami, FL)
- …and resolving discrepancies or potential issues. + Prepares comprehensive files for review by department chairs, medical staff committees, and the Board ... staff documents. + Supports medical staff committees (eg, Medical Executive Committee, Credentialing Committee, Peer Review Committee) by preparing… more
- Humana (Tallahassee, FL)
- …management, provider relations, quality of care, audit, grievance and appeal and policy review . The Behavioral Health Medical Director will develop and present ... health topics to the clinical operations team and healthcare organization. The Medical Director's work includes computer based review of moderately complex… more
- Molina Healthcare (Orlando, FL)
- …administrative incentives + Supervises and manages Medical Directors + Develops medical policies and procedures + Conducts peer review **JOB QUALIFICATIONS** ... Utilization/Quality Program management + Previous leadership experience + Peer review , medical policy/procedure development, and provider contracting experience… more