- 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
- MyFlorida (Chattahoochee, FL)
- …room/off campus treatment appointments or as physician orders. + Providing medical emergency and emergency pregnancy review /drills on shift assigned. + ... a daily basis with accurate documentation. + Assisting the physician /ARNP/PA during resident assessment, treatment, physical examinations, medical… 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...years' claims processing experience is required. + Knowledge of physician practice and hospital coding, and medical … more
- CenterWell (Clearwater, 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
- ChenMed (Tamarac, FL)
- …and explain primary care provider role. Facilitate patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... people to join our team. ESSENTIAL JOB FUNCTIONS: The Primary Care Physician (PCP) is a licensed/Board Certified/Board Eligible trained professional in internal or… more
- HCA Healthcare (Gainesville, FL)
- …physical, psycho-social, financial). 1. Participates in IDT rounds, 1. Conducts utilization review , evaluates clinical information, and communicates findings to ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...on a timely basis in accordance with the NFRMC Utilization Review Plan and managed care contractual… more
- HCA Healthcare (Ocala, 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 ... health coverage as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision benefits, life and… more
- Sedgwick (Tallahassee, FL)
- …narcotic use contract with client. + Maintains accurate record system of pharmacy utilization review and complex pharmacy reviews to include cost savings, ... and dosage, and monitor complex drug regimens; to provide medical necessity reviews to evaluate, implement, and monitor options...and data collection. + Interacts and coordinates work of physician advisors as needed; performs complex review … more
- AdventHealth (Altamonte Springs, FL)
- GENERAL SUMMARY: The Chief Medical Officer (CMO) provides physician leadership and serves in an administrative capacity providing support to the assigned ... responsibility for performance improvement, risk management, safety and clinical quality, continuing medical education, the medical staff office, medical … more
- Rep-Lite (Orlando, FL)
- …improving patient access and outcomes Performance Metrics Include + Revenue and utilization growth + Physician referral network expansion + Report attribution ... conditions. You will be responsible for expanding awareness, increasing treatment utilization in established accounts, and building a strong network of referring… more