- ChenMed (Opa Locka, FL)
- …engagement with patient and family. + Facilitates patient/family conferences to review treatment goals and optimize resource utilization ; provides family ... Participates in surveys, studies and special projects as assigned. + Conducts concurrent medical record review using specific indicators and criteria as approved… more
- ChenMed (North Miami Beach, FL)
- …assess and record patients' progress and adjust and plan accordingly. + Understanding utilization review and how to leverage with inpatient staff for possible ... studies and special projects as assigned. + Conducts concurrent medical record review using specific indicators and...experience required. + A minimum of 1 year of utilization review and/or case management, home health,… more
- Veterans Affairs, Veterans Health Administration (West Palm Beach, FL)
- …coordinated care delivery model. Coordinates with the patient care team to review clinic appointment availability utilization to ensure that clinic schedules ... range of medical clinicians across multiple disciplines (eg medical doctors, nurse practitioners, physician assistants, psychologists, psychiatrists, social… more
- Highmark Health (Tallahassee, FL)
- …drug utilization reports, and write drug monographs for Committee review to develop the Organization's Drug formulary and/OR provide recommendations for NDC ... dose and duration edits, quantity limits, step-care edits, generic sampling medical policy review and development, member facing outreach initiatives… more
- Elevance Health (Miami, FL)
- …**Carelon Medical Benefits Management** **Post Acute Care Benefit Utilization Management** **Schedule: 10:00-7:00 Central Time** **** **Virtual:** This role ... board certified specialty. + Makes physician to physician calls to gather medical appropriate information...decisions. + Brings to their supervisors attention, any case review decisions that require Medical Director … more
- Molina Healthcare (Orlando, FL)
- …administrative incentives + Supervises and manages Medical Directors + Develops medical policies and procedures + Conducts peer review **JOB QUALIFICATIONS** ... 3+ years HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization /Quality Program management +… more
- Veterans Affairs, Veterans Health Administration (Tampa, FL)
- …coordinated care delivery model. They work with the patient care team to review the clinic utilization by using various reports, ensure that the ... patient systems. 3 Ability to learn and utilize basic medical terminology to record patient messages and physician... medical terminology to record patient messages and physician request pertaining to follow-up medical care.… more
- CVS Health (Tallahassee, FL)
- …or experience as a Physician Advisor or working for an Independent Review Organization A Plus +. + Electronic medical systems/record experience. + Managed ... 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 this… more
- Fresenius Medical Center (Venice, FL)
- …staff in problem solving. **PHYSICIANS:** + Facilitates the application process for physician privileges and compliance with FMS Medical Staff By-Laws. + ... implemented by the facility staff. + Maintains integrity of medical records and other FMS administrative and operational records....Responsible for strong Director and physician relationships and facilitating staff relationships with physicians. +… 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