- Cleveland Clinic (Stuart, FL)
- …Support medical staff quality assurance activities such as peer review , ongoing professional practice evaluation, and focused professional practice evaluation. + ... Cleveland Clinic Martin North Hospital is a fully integrated, state-of-the-art medical campus that includes Diagnostic Centers, Outpatient Surgery and a 24-hour… more
- Veterans Affairs, Veterans Health Administration (Bay Pines, FL)
- …them within Primary Care/PACT and assigned outpatient services including CWBY VA Medical Center, (4) Community Based Outpatient Clinics. The Assistant Chief Nurse ... duties, labor mapping, all Electronic Permission Access System requests (EPAS), BLS review for compliance, review of performance appraisals, proficiencies, and… more
- Ryder System (Tallahassee, FL)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** The ... IT infrastructure domains, including data centers, network/ communications, server utilization , virtual environments, storage, application development, and IT Services.… more
- Kemper (Jacksonville, FL)
- …templates, reporting templates & ensure alignment with policies. Ensure effective utilization of QA Teams & manage capacity allocations. Provide project-level ... & performance testing industry best practices & processes in QA organization. Review internal audits & make recommendations on improvements. Mentor QA group to… more
- Bristol Myers Squibb (Tampa, FL)
- …across a global environment. + Assess current setup, configuration, systems, and utilization , and identify and recommend improvements. + Develop training to help end ... best practices to ensure a holistic best-practice approach. + Review the Workday new product releases, identify features and...plans then in effect and may include the following: Medical , pharmacy, dental and vision care. Wellbeing support such… more
- Humana (Hallandale Beach, FL)
- …environmental and psycho-social health issues. + Monitor and maintain awareness of utilization and conducts outreach based on acuity to assess medical /social/BH ... protection. Please be aware that applicants selected for leader review may be asked to provide their social security...more information please visit: Louisiana Board of Ethics (la.gov) Travel : While this is a remote position, occasional … more
- Sedgwick (Tallahassee, FL)
- …and physician filings and decisions on appropriate treatments recommended by utilization review . + Maintains professional client relationships. **ADDITIONAL ... claim files are properly documented and claims coding is correct. + May process complex lifetime medical and/or defined period medical claims which include state… more
- Prime Therapeutics (Tallahassee, FL)
- …well as the development of strategic business roadmaps that integrate both medical and pharmacy solutions. This position will provide leadership and direction ... + Lead the vision, strategy, and implementation of integrating medical and pharmacy solutions, fostering collaboration across departments and ensuring… more
- Sedgwick (Tallahassee, FL)
- …and physician filings and decisions on appropriate treatments recommended by utilization review . + Maintains professional client relationships. **ADDITIONAL ... claim files are properly documented and claims coding is correct. + May process complex lifetime medical and/or defined period medical claims which include state… more
- Cognizant (Tallahassee, FL)
- …experience. * Experience in the analysis and processing of claims for payments, utilization review /quality assurance procedures. * Must be able to work with ... minimum of 2 years of claim processing is required. ** Travel :** None required **About the role:** As Claims Adjudication...HCFA paper or EDI information. * Responsible for reviewing medical records when necessary to determine if service rendered… more