- Highmark Health (Tallahassee, FL)
- …and financial stakeholders **Preferred** + Experience with medical policy and utilization management functions + Medical coding experience **LICENSES or ... both internally developed and vendor-sourced criteria. This includes proactive monitoring, review , and timely updates in response to new evidence, regulatory… 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 ... Qualifications:** + Internal Medicine, or Family Medicine specialties preferred. + Utilization Management or Appeals experience preferred. For candidates working… more
- MyFlorida (Chattahoochee, FL)
- …physician/ARNP/PA during resident assessment, treatment, physical examinations, medical/psychiatric/ behavioral issues and preparing resident for outside ... or as physician orders. + Providing medical emergency and emergency pregnancy review /drills on shift assigned. + Providing immediate intervention to de-escalate a… more
- HCA Healthcare (Trinity, FL)
- …Healthcare Quality) OR CHCQM (Diplomate in American Board of Quality Assurance and Utilization Review Physicians) _Individuals without CPHQ or ABQUARP will be ... 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 (Tallahassee, FL)
- …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 ... through clinical screenings and assessments in collaboration with both hospital Case Management and the Rehab Medical Director. Job Duties and Responsibilities: +… more
- HCA Healthcare (Miami, FL)
- … + Experience or 2 years of critical care experience + Certification in case management or utilization review preferred + InterQual experience preferred HCA ... 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
- Battelle Memorial Institute (Hurlburt Field, FL)
- …validity and significance of collected data, prepare written notes integrating behavioral observations and test results, make recommendations for further action + ... Medical Evaluation Board (MEB), Temporary Disability Retirement List (TDRL) status review , Physical Evaluation Board (PEB), and clinical consultations from various… more
- HCA Healthcare (Largo, FL)
- …guidelines. Participates in developing department goals and clinical programming. + Performs utilization review as assigned. + Helps with Process and Quality ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services...or experience in the area of clinical practice and/or management + Currently licensed as one of the following… more
- Highmark Health (Tallahassee, FL)
- …and mentorship in areas of expertise and architecture to peers, developers, management , and business users. **Key Responsibilities:** + Lead the design and ... effective application of appropriate design standards, methods, and tools. + Review application designs to ensure optimal technology selection, efficient resource … more
- HCA Healthcare (Tallahassee, FL)
- …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 ... are responsible for the safe, effective, evidence-based, and cost-effective selection and utilization of medications for the patients in the ICU. They use advanced… more