- CenterWell (Deland, FL)
- …care plans and interpreting patient needs, while adhering to Company, physician , and/or health facility procedures/policies. + Manages the assignment of caregivers. ... review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and conducts… more
- Abbott (Miami, FL)
- …This includes influencing stakeholders within the hospital, driving product utilization , support on contracting, relationship development, relationship management ... on clinical differentiation in the procedure, value proposition, product launch, physician onboarding, early case coverage and training. + Influence stakeholders… more
- Sedgwick (Tallahassee, FL)
- …use contract with client. + Maintains accurate record system of pharmacy utilization review and complex pharmacy reviews to include cost savings, trends, and ... data collection. + Interacts and coordinates work of physician advisors as needed; performs complex review of cases...complex review of cases to identify referral for case management as needed. + Participates in client meetings and… more
- MyFlorida (Chattahoochee, FL)
- …seclusion/restraint processes utilizing required documentation/forms. + Assist the medical physician during sick calls, during physical examinations, or as needed. ... ensures that appropriate documentation accompanies residents. + Designates (in conjunction with physician ) the mode of travel for residents with medical problems who… more
- Humana (Tallahassee, FL)
- …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , discharge ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management + Utilization management experience in a… more
- AdventHealth (Daytona Beach, FL)
- …& Decision Support. Serves as regional executive liaison with Revenue Cycle, Utilization Review, Case Management , Supply Chain, Managed Care, Corporate ... resource policies and effective use of premium labor, effective supply chain management , well-vetted physician investment and capital investment. + Assist… more
- ChenMed (Miami, FL)
- …spot trends + Extensive knowledge of healthcare/medical economics data such as hospital/ physician /ASC claims, utilization data, and healthcare industry coding ... JOB DUTIES/RESPONSIBILITIES:** + Analyzes and interpret enrollment, revenue, and claims ( utilization and unit cost) data to identify and solve business problems… more
- Travelers Insurance Company (Tallahassee, FL)
- …skills **What is a Must Have?** + Licensed MD + 5 years clinical and utilization management experience + Certified by the American Board of Medical Specialties ... the leading edge of the P&C industry. Develop medical management strategies that help injured employees return to work...+ Provide overall program leadership as the organization's lead physician . Serve as the key enabler and facilitator for… more
- CVS Health (Tallahassee, FL)
- …You can have life-changing impact on our members, who are enrolled in Care Management and present with a wide range of complex health and social challenges. With ... exciting opportunity as we grow and expand our Care Management Programs to change lives in new markets across...assists with securing DME, and helps to ensure timely physician follow-up. - Understands Payer/Plan benefits, policies, procedures, and… more
- CVS Health (Tallahassee, FL)
- …You can have life-changing impact on our members, who are enrolled in Care Management and present with a wide range of complex health and social challenges. With ... exciting opportunity as we grow and expand our Care Management Programs to change lives in new markets across...assists with securing DME, and helps to ensure timely physician follow-up + Understands Payer/Plan benefits, policies, procedures, and… more