- HCA Healthcare (Gainesville, FL)
- …Case Management is preferred + BSN is preferred + Certification in Case Management , Nursing or Utilization Review is preferred HCA Florida North Florida ... with physicians, patients, families, hospital staff, and outside agencies + Performs utilization management reviews and communicates information to third party… more
- Elevance Health (FL)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... a State agency.*_ **Preferred Skills, Capabilities and Experiences:** + 1-2 years Utilization Management experience strongly preferred. + Strong oral, written,… more
- Highmark Health (Tallahassee, FL)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review , the incumbent participates as the...member of the multidisciplinary team for case and disease management . They will advise the multidisciplinary team on cases,… more
- HCA Healthcare (Sanford, FL)
- …in Case Management is preferred + BSN is preferred + Certification in Case Management , Nursing or Utilization Review is preferred HCA Florida Lake Monroe ... with physicians, patients, families, hospital staff, and outside agencies + Performs utilization management reviews and communicates information to third party… more
- HCA Healthcare (Kissimmee, FL)
- …and admission status issues through established chain of command. + Performs utilization management reviews and communicates to third party payors. + ... at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical… more
- HCA Healthcare (Coral Springs, FL)
- …to include but not limited to: Clinical initiatives that impact drug utilization , clinical education and staff development, management of appropriate drug ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services...plan that ensures positive patient outcomes and appropriate drug utilization + Analyze drug spend trends to identify areas… more
- HCA Healthcare (Gainesville, FL)
- …oncology, transplant, and/or cellular therapy is required. + Certification in case management , nursing, or utilization review desired. + Bachelors ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services...clinical excellence behind the scenes in data science, case management or transfer centers. Unlock your potential at HCA… more
- HCA Healthcare (Brooksville, FL)
- …Healthcare Quality) OR CHCQM (Diploma in American Board of Quality Assurance and Utilization Review Physicians). _Individuals without CPHQ or_ CHCQM _will be ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services...a healthcare environment + Previous experience in accreditation, quality, utilization management , or risk management … more
- CenterWell (Daytona Beach, FL)
- …in patient experience, quality of care, clinical outcomes, and avoidable utilization *Periodically review clinician charts to identify opportunities in ... our primary care team, combining clinical practice with leadership and operational management to ensure high-quality patient care and alignment with Value-Based Care… more
- CenterWell (Jacksonville, FL)
- …performance in patient experience, quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify opportunities ... our primary care team, combining clinical practice with leadership and operational management to ensure high-quality patient care and alignment with Value-Based Care… more