- Evolent (Tallahassee, FL)
- …reviews to be completed by the subject matter expert. . Discusses determinations ( peer to peer phone calls) with requesting physicians or ordering providers, ... provides clinical rationale for standard and expedited appeals. . Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD … more
- Evolent (Tallahassee, FL)
- …+ Provides clinical rationale for standard and expedited appeals. + Discusses determinations ( peer to peer phone calls) with requesting physicians or ordering ... available, within the regulatory timeframe of the request. + Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review… more
- CVS Health (Tallahassee, FL)
- …consistent responses to members and providers related to precertification, concurrent review , and appeal request. This position is primarily responsible for ... including prior authorization and precertification as well as concurrent review . Cases could focus on inpatient or outpatient, acute...inpatient or outpatient, acute and post-acute as well as peer to peer calls and first level… more
- AdventHealth (Altamonte Springs, FL)
- …Utilization Management, the Physician Advisor is responsible for providing clinical review of utilization, claims management, and quality assurance related to ... clinical questions from Utilization Management staff involved in authorizations, concurrent review , and denials + Assists with interpretation of specific application… more
- Evolent (Tallahassee, FL)
- …reviews to be completed by the subject matter expert. + Discusses determinations ( peer to peer phone calls) with requesting physicians or ordering providers, ... provides clinical rationale for standard and expedited appeals. + Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD … more
- Evolent (Tallahassee, FL)
- …reviews to be completed by the subject matter expert. + Discusses determinations ( peer to peer phone calls) with requesting physicians or ordering providers, ... provides clinical rationale for standard and expedited appeals. + Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD … more
- University of Miami (Miami, FL)
- …or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . APP CORE ... management for side effects related to hematologic oncologic treatment. + Assist with Peer -to- Peer authorizations and filling out medical forms for patients. +… more
- University of Miami (Miami, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Research ... to develop and execute research projects.- Publish research findings in peer -reviewed scientific journals and present research at conferences and meetings.- Assist… more
- MyFlorida (Fort Pierce, FL)
- …overseeing the work of those staff during an annual or supplemental review . Collecting and requesting information, completing work papers to ensure compliance with ... report to the supervisor for proof reading and editing. Participates as a peer reviewer on annual or supplemental compliance reviews with other regional staff.… more
- University of Miami (Miami, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Sebastian ... collaborative team scientists, with a track record of excellence in research, peer -reviewed publications, and the potential to develop and/or lead clinical trials,… more