- AdventHealth (Tampa, FL)
- …collaboration with physicians, nursing and HIM coders, the Second Level Reviewer I strategically facilitates and obtains appropriate and quality physician ... complexity of care of the patient. The Second Level Reviewer I educates members of the patient care team...mortality (ROM), and quality. Completes accurate and timely record review to ensure the integrity of documentation compliance. Completes… more
- AdventHealth (Orlando, FL)
- …collaboration with physicians, nursing and HIM coders, the Second Level Reviewer I strategically facilitates and obtains appropriate and quality physician ... complexity of care of the patient. The Second Level Reviewer I educates members of the patient care team...(ROM), and quality. + Completes accurate and timely record review to ensure the integrity of documentation compliance. +… more
- Centers Plan for Healthy Living (Margate, FL)
- …For Healthy Living is currently accepting applications for Full Time Registered Nurse without experience. The Utilization Management Clinical Reviewer works ... their home to improve their quality of life. Utilization Management Clinical Reviewer will assess and process all authorization requests to determine medical… more
- Zelis (FL)
- …interests that shape who you are. Position Overview The Inpatient DRG Reviewer will be primarily responsible for conducting post-service, pre-payment and post pay ... AHA Coding Clinic and client specific coverage policies. Conduct prompt claim review to support internal inventory management to achieve greatest savings for… more
- Actalent (Fort Lauderdale, FL)
- Actalent is Hiring a Behavioral Health Utilization Review Nurse Job Description We are seeking a dedicated Utilization Management Nurse (UMN) who will work ... internal process development, and provide education to the team on utilization review -related issues. Responsibilities + Review prior authorization requests for… more
- Actalent (Sunrise, FL)
- Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing requests for ... with the interdisciplinary team, the UMN handles tasks related to utilization review across various specialties, medical treatments, and services. The role involves… more
- Zelis (St. Petersburg, FL)
- …Effective and proven leadership experience is a must as recommendations to the Nurse Reviewer 's regarding their claim management is required. Additionally, this ... you are. Position Overview The Sr. Supervisor, Clinical Chart Review is focused on supervising a team of Clinician's...as needed Quality Assurance and complete bi-annual assessment of Nurse Reviewer performance. Report these results to… more
- Molina Healthcare (Tampa, FL)
- …set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing clinical knowledge and experience, ... responsible for review of documentation to ensure medical necessity and appropriate...quality of care issues. + Assists with Complex Claim review including DRG Validation, Itemized Bill Review ,… more
- University of Miami (Doral, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The ... an exciting opportunity for a Full Time Clinical Research Nurse 2 to work at the UHealth medical campus...Unit (CTU)staff and Clinical Research Services Senior Manager to review the clinical trial treatment order-set and individual patient… more
- University of Miami (Plantation, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The ... an exciting opportunity for a Full Time Clinical Research Nurse 2 to work at the UHealth Medical campus...Unit (CTU)staff and Clinical Research Services Senior Manager to review the clinical trial treatment order-set and individual patient… more