• Medical Director Physician Advisor UM

    AdventHealth (Altamonte Springs, FL)
    …role you will contribute:** The Physician Advisor provides primary support for Utilization Management (UM) and secondary support for Care Management (CM) ... documentation, patient safety, and quality outcomes. Through primary support of Utilization Management , the Physician Advisor is responsible for providing… more
    AdventHealth (08/07/25)
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  • Physician (Psychiatry) - Section Chief

    Veterans Affairs, Veterans Health Administration (West Palm Beach, FL)
    …(HRO), performs psychiatry Quality of Care audits and functions as the Department Physician Utilization Management Advisor (PUMA) to ensure compliance. ... of mental health. Incumbent collaborates and participates with facility leadership and Utilization Management to ensure practices follow JC, CARF, and CO… more
    Veterans Affairs, Veterans Health Administration (08/14/25)
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  • Physician - Physician Advisor

    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 ... **Details** + **Department** : Case Management + **Schedule:** Full Time | Hybrid (frequently...**Position Highlights** Ascension St. Vincent is looking for a Physician Advisor to join our team. We are looking… more
    Ascension Health (08/13/25)
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  • Licensed Physician Reviewer - Ortho…

    ChenMed (Miami, FL)
    …people to join our team. The Physician Reviewer is the primary physician reviewer for Utilization Management /Clinical Appropriateness review cases in our ... Process and Quality improvement in our developing area of Delegated Utilization Management . **ESSENTIAL JOB DUTIES/RESPONSIBILITIES:** + Provides Delegated… more
    ChenMed (06/05/25)
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  • Registered Nurse ED Utilization

    AdventHealth (Tampa, FL)
    …diseases. **The ro** **le you'll contribute:** The role of the Emergency Department Utilization Management (UM) Registered Nurse (RN) is to use clinical ... standards. When screening criteria does not align with the physician order or a status conflict is indicated, the...for additional review as determined by department standards. The Utilization Management Nurse is accountable for a… more
    AdventHealth (08/08/25)
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  • Registered Nurse Utilization

    AdventHealth (Tampa, FL)
    …cancer and other diseases. **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse (RN) is to use clinical expertise ... standards. When screening criteria does not align with the physician order or a status conflict is indicated, the...of critical care nursing experience preferred. 1 years of utilization management experience preferred. This facility is… more
    AdventHealth (08/14/25)
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  • Medical Director, MSK Surgery

    Evolent (Tallahassee, FL)
    …reviews appeal cases and/or attends hearings for discussion of utilization management decisions. + Strong partnership with Physician Business Managers to ... well as health plan members and staff whenever a physician `s input is needed or required. Responsible for clinical...needed for new hires to educate and train on Utilization management system and Field Medical Director… more
    Evolent (05/20/25)
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  • Physician (Primary Care)-Pain…

    Veterans Affairs, Veterans Health Administration (Bay Pines, FL)
    …departments and staff on projects pertaining to the delivery of comprehensive Pain Management . May function as the collaborating physician for the inpatient and ... Primary Care Service is seeking an experienced and dynamic Primary Care Pain Physician . Ideal applicants are those who want to contribute to the achievement of… more
    Veterans Affairs, Veterans Health Administration (08/14/25)
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  • Physician (Mental Health) - Associate Chief…

    Veterans Affairs, Veterans Health Administration (Miami, FL)
    …achieve goals for eligibility, referral and authorization, care coordination, and utilization management to ensure improved Veteran experience. Makes ... improving the Veteran's experience and outcomes. Defines mental health policies, utilization management process and procedures, financial and utilization more
    Veterans Affairs, Veterans Health Administration (06/28/25)
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  • Fee Basis Physician (Radiation Oncology)

    Veterans Affairs, Veterans Health Administration (West Palm Beach, FL)
    …West Palm Beach VA Medical Center is currently seeking a Fee Basis Physician (Radiation Oncology). 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
    Veterans Affairs, Veterans Health Administration (06/08/25)
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