- Terracon (Sarasota, FL)
- …operations of a department including staff training, development, and performance review , utilization of equipment and facilities, safety oversight, quality ... of services and work product, timely delivery of services and deliverables, and adherence to policies and procedure. Plan for and participate in business development activities to identify, develop, win, and execute project opportunities and build and maintain… more
- Terracon (West Palm Beach, FL)
- …operations of a department including staff training, development, and performance review , utilization of equipment and facilities, safety oversight, quality ... of services and work product, timely delivery of services and deliverables, and adherence to policies and procedure. Plan for and participate in business development activities to identify, develop, win, and execute project opportunities and build and maintain… more
- Terracon (Winter Park, FL)
- …operations of a department including staff training, development, and performance review , utilization of equipment and facilities, safety oversight, quality ... of services and work product, timely delivery of services and deliverables, and adherence to policies and procedure. Plan for and participate in business development activities to identify, develop, win, and execute project opportunities and build and maintain… more
- Datavant (Tallahassee, FL)
- …healthcare. The purpose of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for medical ... author appeal letter Identification of referrals to the medical director for review + Select appropriate preferred and contracted providers + Provide proper… more
- Actalent (Orlando, FL)
- …systems + Work with providers to approve or recommend determinations based on review findings + Educate providers on utilization processes to ensure high-quality ... Clinical Review Nurse - Concurrent Review Location:...preferred) + Knowledge of Medicaid or Medicare regulations and utilization management processes + Proficiency in Microsoft Word, Excel,… more
- Cushman & Wakefield (Miami, FL)
- …format for client delivery + Assist the team in performing site assessments to review space efficiencies, utilization metrics and supply and demand studies + ... ways of working + Conducts weekly meetings with direct reports to review open requests/projects **Process Skills** + Strong verbal presentation skills, ability to… more
- Centene Corporation (Tallahassee, FL)
- …discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in ... health management systems according to utilization management policies and guidelines + Works with healthcare...or provide recommendations based on requested services and concurrent review findings + Assists with providing education to providers… more
- MyFlorida (Alachua, FL)
- …performance indicators. Plans workloads, work flows, deadlines, work objectives and time utilization with employees. MONITORING AND QUALITY REVIEW : Reviews and ... history checks through local law. Knowledge, skills and abilities, including utilization of equipment, required for the position: Knowledge of social services… more
- Molina Healthcare (Orlando, FL)
- …on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. JOB DESCRIPTION Job SummaryProvides support for clinical member ... services review assessment processes. Responsible for verifying that services are...to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications *… more
- Molina Healthcare (Tampa, FL)
- JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically ... with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At least 2… more