- Molina Healthcare (Tampa, FL)
- …to learn new programs. Preferred Qualifications * Experience with utilization/ quality program management. * Managed care experience. * Peer review ... programs within specific markets/regions. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Provides… more
- HCA Healthcare (Atlantis, FL)
- …utilization, and quality profiling. Serves as a member of hospital's peer review committees as requested. Business Development and Payer Relations + ... environment of quality and cost improvement, and develops systems to review utilization of resources and objectively measure outcomes of care in the inpatient… more
- HCA Healthcare (Kissimmee, FL)
- …with the Stroke Center Medical Director coordinates and provides support to the clinical peer review process for stroke center patients: + Accurate and timely ... assistance (tuition, student loan, certification support, dependent scholarships) + Colleague recognition program + Time Away From Work Program (paid time off,… more
- Wounded Warrior Project (Jacksonville, FL)
- …that reflect program theory and strategic goals. + Collaborate closely with peer leaders in warrior research and program data governance to ensure alignment ... Impact Evaluation Manager leads the strategy and execution of program evaluation within the Mission Data & Insights team....in research priorities, data quality practices, and shared methodologies across the Mission Data… more
- Elevance Health (Tampa, FL)
- …to members and providers. + Provides guidance for clinical operational aspects of a program . + Conduct peer -to- peer clinical appeal case reviews with ... management responsibilities including clinical policy development, improvement of quality , cost, and outcomes, program development/implementation, and… more
- Molina Healthcare (Tampa, FL)
- …to learn new programs. Preferred Qualifications * Experience with utilization/ quality program management. * Managed care experience. * Peer review ... of care concerns. * Participates in preparation for national committee for quality assurance (NCQA) and utilization review accreditation commission (URAC)… more
- MyFlorida (Orlando, FL)
- …in the writing and development of public health reports or articles for peer review or professional refereed journals. Attends and/or facilitates meetings and ... and emerging infections in Orange County. Works with Epidemiology Program Manager to run reports for quality ...to write in a technical format for journal and peer referred journals + Ability to formulate policies and… more
- Elevance Health (Tampa, FL)
- …Freedom Health, and Optimum Healthcare Plans and will be responsible for utilization review case management for these markets. May be responsible for developing and ... implementing programs to improve quality , cost, and outcomes. May provide clinical consultation and...+ Provides guidance for clinical operational aspects of a program . + Perform utilization management reviews to determine medical… more
- Fresenius Medical Center (Hollywood, FL)
- …values and customer service philosophy. Adheres to the FMCNA Compliance Program , including following all regulatory and FMS policy requirements. Ensure provision ... of quality patient care while maintaining cost-effective clinical operations in...programs. Adheres to all requirements of the FMCNA Compliance Program , and FMS patient care and administrative policies as… more
- MyFlorida (Tallahassee, FL)
- …and consultative work in the Fiscal Unit of the Bureau of WIC Program Services. The incumbent is responsible for monitoring the financial management processes of ... oversight of the daily operations of the unit, participating in developing program cost projections and coordinating the Bureau's spending plan and other required… more
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