- Select Medical (Miami, FL)
- …Performs basic chart review activities with appropriate staff for outcome utilization , infection control and medical CQI indicators. Analyzes results of ... **West Gables** **Rehabilitation Hospital** *A joint venture with Select Medical * **Location: Miami, FL** **$10,000 Sign-on Bonus** **Director of Quality… more
- Cognizant (Tallahassee, FL)
- …+ Experience in the analysis and processing of claims for payments, utilization review /quality assurance procedures. + Excellent problem-solving skill in ... with stakeholders and other teams. **Primary Responsibilities** : + Review claim system data and verify against UB or...UB or HCFA paper or EDI information. + Evaluate medical records to determine if the service rendered was… more
- HCA Healthcare (Tallahassee, FL)
- …position if current and compliant** + **Certification in Case Management, Nursing, or Utilization Review , preferred** + **Three years of nursing experience in ... 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… more
- Humana (Tallahassee, FL)
- …focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with health ... part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice… more
- University of Miami (Hialeah, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Manager, ... a Full Time Manager, Supply Chain Asset Management to work in the UHealth Medical Campus. Core Job Summary The Asset Management Manager is responsible for managing… 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. ... a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in...+ Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. +… more
- Cognizant (Tallahassee, FL)
- …guidelines and regulations + Experience in the analysis and processing of claims, utilization review /quality assurance procedures + Must be able to work with ... Based** Claims Processors to join our growing team. The ** Medical ** **Claims Processor** is responsible for the timely and...HCFA paper, or EDI information. + Responsible for reviewing medical records when necessary to determine if the service… more
- Fresenius Medical Center (Venice, FL)
- …communicated to and implemented by the facility staff. + Maintains integrity of medical records and other FMS administrative and operational records. + Complies with ... as pertinent. **STAFF:** + Responsible for implementation of FMS staffing, and medical supply models, to provide quality patient care, and makes recommendations. +… 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 ... behavioral/mental health + Experience in a managed care, case management, or utilization review setting + Strong understanding of behavioral health diagnoses,… more
- MyFlorida (Tallahassee, FL)
- MEDICAL /HEALTH CARE PROG ANALYST - SES - 64055877 Date: Aug 14, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... . Requisition No: 858520 Agency: Department of Health Working Title: MEDICAL /HEALTH CARE PROG ANALYST - SES - 64055877 Pay Plan: SES… more