- Actalent (Sunrise, FL)
- …staff to direct utilization and capture data effectively. Responsibilities + Review prior authorization requests for medical necessity and appropriateness, utilizing ... standardized Review Criteria. + Coordinate with the Medical Director/Physicians for...the development of programs, policies, and procedures for continuous quality improvement. + Assure adherence to company and department… more
- Centene Corporation (Tallahassee, FL)
- …a fresh perspective on workplace flexibility. **Position Purpose:** Performs a clinical review and assesses care related to mental health and substance abuse. ... appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of… more
- SitusAMC (St. Petersburg, FL)
- …but act local - come join our team! This position is responsible for quality control (QC) of mortgage collateral documents for SitusAMC clients. This role is ... QC checks on input data to ensure accuracy + Review imaged documents, identify, and perform data input of...required + Assist in the creation or modification of quality industry documents according to department standards, following defined… more
- Abbott (Orlando, FL)
- …allowing people to restore their health and get on with their lives. The Payment Review & Administration SME is responsible for leading the review and analysis ... operating procedures, and contribute to process improvement initiatives across the payment review and administration functions. **What You'll Work On** + Analyze and… more
- Cleveland Clinic (Stuart, FL)
- …+ Performs research follow-up studies. + Assists in data analysis. + Participates in quality monitoring thru the review of records and treatment plans for ... practice provider (APP) will play a key role in delivering high- quality , patient-centered care across **outpatient, inpatient, and infusion suite settings** .… more
- Cleveland Clinic (Weston, FL)
- …multi-disciplinary care team or with other specialty areas as necessary. + Participates in quality monitoring thru the review of records and treatment plans for ... care. In this rewarding role, you will be instrumental in delivering **high- quality , patient-centered care** across both outpatient and surgical settings. We are… more
- Datavant (Tallahassee, FL)
- …education. Operations & Reporting + Track and report on coding productivity and quality metrics for leadership review . + Maintain coding policies, procedures, ... of hospital inpatient encounters. This role includes staff supervision, quality assurance, workflow management, training, and collaboration with other departments… more
- University of Florida (Lake County, FL)
- …specified health promotion, education and/or prevention programs. + Participating in peer review , quality assurance, provider meetings, and other clinical and ... + Following established departmental policies, procedures, and objectives, continuous quality improvement objectives, and safety, environmental, and/or infection control… more
- University of Florida (Lake County, FL)
- …specified health promotion, education and/or prevention programs. + Participating in peer review , quality assurance, provider meetings, and other clinical and ... + Following established departmental policies, procedures, and objectives, continuous quality improvement objectives, and safety, environmental, and/or infection control… more
- University of Florida (Lake County, FL)
- …specified health promotion, education and/or prevention programs. + Participating in peer review , quality assurance, provider meetings, and other clinical and ... + Following established departmental policies, procedures, and objectives, continuous quality improvement objectives, and safety, environmental, and/or infection control… more