• Field Medical Director , Radiology (Urology)

    Evolent (Tallahassee, FL)
    …as Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines. + Aids and acts as a resource to Initial ... reviews to be completed by the subject matter expert. + Discusses determinations ( peer to peer phone calls) with requesting physicians or ordering providers,… more
    Evolent (05/03/25)
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  • Field Medical Director, Cardiology

    Evolent (Tallahassee, FL)
    … Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines. + Ensures documentation of all communications with ... + Provides clinical rationale for standard and expedited appeals. + Discusses determinations ( peer to peer phone calls) with requesting physicians or ordering… more
    Evolent (02/14/25)
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  • Medical Tech II

    Community Health Systems (Naples, FL)
    …is performed as required. + Analyzes quality control data. Participates in Peer Review data analysis. Troubleshoots and corrects out of range results timely ... and reliable test results by adhering to a strict quality control program and performs instrument function...to policies of personnel daily time management and oversees peer review for specific department. **Essential Functions**… more
    Community Health Systems (05/06/25)
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  • Research Advanced Practice Registered Nurse…

    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 ... scientists. This is an out-patient position for a vastly growing myeloma clinical program . + Assesses the physical and psychosocial status of clients by means… more
    University of Miami (04/13/25)
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  • Lead Engineer, Applications

    Molina Healthcare (Miami, FL)
    …program or program change is possible within existing system. + Conducts peer review of other developers (internal and contract staff) to ensure standards ... and quality . + Responsible for quality deliveries for...+ Responsible for presentations and solutions submitted to technical peer review committees. + Ownership to provide… more
    Molina Healthcare (05/10/25)
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  • Lead Engineer, Applications…

    Molina Healthcare (Tampa, FL)
    …program or program change is possible within existing system. + Conducts peer review of other developers (internal and contract staff) to ensure standards ... and quality . + Responsible for quality deliveries for...+ Responsible for presentations and solutions submitted to technical peer review committees. + Ownership to provide… more
    Molina Healthcare (03/13/25)
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  • Biological Scientist IV

    MyFlorida (Tallahassee, FL)
    …include but are not limited to; slide sets, fact sheets, research publications, peer review papers, quality assurance/technical assistance visits, reports ... modeling as appropriate. Collaborate with other Units in the Surveillance Program as needed to further investigate HIV data trends. Provide technical… more
    MyFlorida (05/08/25)
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  • Business Default Specialist (Pensacola, FL)

    TEKsystems (Pensacola, FL)
    …to address and naturally driven ability + Multitasking is a must Performance: + Quality Assurance to monitor their calls. Mentor/ Peer desk audits + balance ... home efficiently and effectively (attached in this email to review ) Job Description: To review , control and...how much they are collecting + based on the peer group, the accounts they are assigned and how… more
    TEKsystems (05/01/25)
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  • APP Team Manager - Anesthesiology - Full Time

    University of Miami (Doral, 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) . The APRN ... FUNCTIONS + Develops, leads and manages the clinical practice, quality and safety of patient care of an interdisciplinary...side effects related to oncologic treatment. + Assist with Peer -to- Peer authorizations and filling out medical forms… more
    University of Miami (04/16/25)
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  • Finance & Accounting Director II - SES

    MyFlorida (Tallahassee, FL)
    …WIC Breastfeeding Peer Counseling Reports and other grant reports. Analyzes program , financial, and administrative data to evaluate and improve WIC Program ... as well as the Bureau. Coordinates an ongoing review of the program 's financial management processes...Oversees monitoring of Prompt Payment Law compliance for the program and initiates quality assurance initiatives when… more
    MyFlorida (05/01/25)
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