- Veterans Affairs, Veterans Health Administration (West Palm Beach, FL)
- …systems of health care by participating in programs, following policies, improving utilization of resources and suggesting process changes for clinical programs in ... the Radiation Oncology Section. NOTE: The utilization of the Fee Basis appointments are focused on...outpatient clinics and/or inpatient wards. Participates in regular peer review activities. Maintains patient records and files. Follows HIPPA… more
- Evolent (Tallahassee, FL)
- …role in **Performance Suite risk arrangements with payers and strategic utilization management initiatives.** This is an opportunity for a **Cardiologist** to ... cardiovascular programs that include improvements to clinical effectiveness of utilization management (UM) and risk-based models.** + Process improvement and… more
- MyFlorida (St. Petersburg, FL)
- …referrals to medical providers as needed. + Processes stat referrals as assigned. Data Review + Verify data requested from source documents is entered with a 95% ... accuracy rate. + Review statistical reports in Logi. + Assist the Business...match claims and authorization. Knowledge, skills and abilities, including utilization of equipment, required for the position : +… more
- Sunrise Senior Living (Coral Gables, FL)
- …key to achieving customer engagement. + Lead the development and regular review of the engagement improvement plan. + Resolve customer concerns effectively through ... delivery and institute and ensure corrective action in a timely manner. + Review customer and secret shopper surveys and act accordingly by instituting appropriate… more
- Travelers Insurance Company (Tallahassee, FL)
- …which can impact claim outcomes. Organize and coordinate Travelers' medical review functions. This includes interpreting Federal and State regulations and medical ... guidelines to establish medical review policies. Works in close collaboration with the Claim...Have?** + Licensed MD + 5 years clinical and utilization management experience + Certified by the American Board… more
- MyFlorida (Tallahassee, FL)
- …Profile (application) must be complete in its entirety. + Work History (in easy to review chronological order) Consists of: + + Any position held by a State of ... your packet may be held up at the final review step. NOTE: Responses to qualifying questions must be...KNOWLEDGE, SKILLS AND ABILITIES Knowledge, skills and abilities, including utilization of equipment, expected to master in order for… more
- CenterWell (Tallahassee, FL)
- …+ Monitor plan performance and proactively bring issues to the forefront for review + Support new business implementations with a goal of ensuring all pharmacy ... and present to client + Escalate issues for immediate review and action whenever necessary + Request, review...internal partners and the Medicaid market to manage pharmacy utilization and spend + Manage escalated member, client and… more
- MyFlorida (Bradenton, FL)
- …associated plans. + Conducts annual reviews and periodic revisions according to the review schedule; Coordinates review and revision of plans not directly ... associated plans. + Conducts annual reviews and periodic revisions according to the review schedule; Coordinates review and revision of plans not directly… more
- HCA Healthcare (Gainesville, FL)
- …monitoring location of equipment in the facilities and reporting of facility utilization /need. **In this role you will be responsible for:** + Responsible for ... including entry and exit forms, and rental invoices. + Review , audit, and retain all monthly rental reports and...properly and in a timely manner as outlined. + Review all stats orders for rental equipment made at… more
- University of Miami (Miami, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The ... assignments in order to provide safe, quality care. + Responsible for the utilization and maintenance of appropriate nursing care plans, and assure nursing staff is… more