- Ascension Health (Jacksonville, FL)
- …5 years of recent work experience in a hospital setting, preferably with some Physician Advisory/ Utilization Management work experience. If you are ready to ... **Details** + **Specialty** : Case Management + **Subspecialty:** Physician Advisor + **Schedule** : Full Time | Hybrid (frequently on site) + **Call Schedule:** No… more
- ChenMed (Miami, FL)
- …to join our team. The Physician Reviewer is the primary physician reviewer for Utilization Management/Clinical Appropriateness review cases in our ... organization. Other duties include advising other physician reviewers and attending daily calls with health plan teams and our local teams assisting with this… more
- HCA Healthcare (Kissimmee, FL)
- …such as patient flow, patient satisfaction, practice volume, billing and collections, service utilization , coding, physician and staff training + You will have ... colleagues invested over 156,000 hours impacting our communities. As a Director of Physician Services II with HCA Florida Osceola Hospital, you can be a manager… more
- HCA Healthcare (Bradenton, FL)
- …affairs. + Serves as a consultant to hospital Medical Staff Services regarding physician credentialing, utilization , and quality profiling. Serves as a member of ... quality management and promote optimum patient experience. Major Responsibilities: Physician Alignment + Leads clinical performance expectations that support the… more
- Elevance Health (Pembroke Pines, FL)
- …to formulary and prescription benefits. + Generates reports relating to rebates, physician utilization , Beers Criteria, Reliance members, and other ad hoc ... reports. + Maintains record keeping of prior authorizations, rebates, and monthly reports. **Minimum Requirements:** + Requires HS diploma or equivalent and minimum of 1 year of pharmacy experience; or any combination of education and experience, which would… more
- CenterWell (Tallahassee, FL)
- …the courage to innovate. **Additional Information** Will report to the Director of Physician Strategy at Utilization Management. The Medical Director conducts ... their scope. The Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market care… more
- Community Health Systems (Naples, FL)
- …and discharge planning. + Refers cases not meeting criteria to the Physician Advisor or Utilization Management Committee and ensures appropriate follow-up. ... + Identifies avoidable days and implements communication systems to address and resolve them effectively. + Coordinates discharge planning and social services functions to ensure compliance with federal and state laws and Joint Commission standards. + Acts as… more
- Highmark Health (Tallahassee, FL)
- …Inc. **Job Description :** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in ... and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician... utilization review, the incumbent participates as the physician member of the multidisciplinary team for case and… more
- Veterans Affairs, Veterans Health Administration (Gainesville, FL)
- …Florida/ South Georgia VA Healthcare System is looking for a Emergency Medicine Chief Physician to join the Medical Care Service at the Malcolm Randall VA Medical ... Center in Gainesville, Fl. The Physician will provide direct patient care in the Urgent...the success of those efforts. Work with the VA Utilization Management (UM) department staff to monitor the preadmission… more
- Veterans Affairs, Veterans Health Administration (Miami, FL)
- …Miami VA Healthcare System Medical Center is currently seeking a Fee Basis Physician (Primary Care). The incumbent will be responsible for maintaining and improving ... systems of health care by participating in programs, following policies, improving utilization of resources and suggesting process changes for clinical programs in… more