- Evolent (Tallahassee, FL)
- …mission. Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management** at Evolent will serve as a point of contact for ... and client contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, Utilization … more
- Highmark Health (Tallahassee, FL)
- …determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by ... the physician against medical policy criteria. The incumbent then uses...prior authorization or appeals against medical policy through the Utilization Review system. Update the system records… more
- Ascension Health (Jacksonville, FL)
- …5 years of recent work experience in a hospital setting, preferably with some Physician Advisory/ Utilization Management work experience. If you are ready to ... **Details** + **Specialty** : Case Management + **Subspecialty:** Physician Advisor + **Schedule** : Full Time |...talented group of physicians apply today! **Responsibilities** : + Review medical records of identified patients to assist with… more
- HCA Healthcare (Kissimmee, FL)
- …such as patient flow, patient satisfaction, practice volume, billing and collections, service utilization , coding, physician and staff training + You will have ... colleagues invested over 156,000 hours impacting our communities. As a Director of Physician Services II with HCA Florida Osceola Hospital, you can be a manager… more
- ChenMed (Miami, FL)
- … Physician Reviewer is the primary physician reviewer for Utilization Management/Clinical Appropriateness review cases in our organization. Other duties ... include advising other physician reviewers and attending daily calls with health plan...medicine preferred + At least one (1) year of utilization review experience preferred **PAY RANGE:** $198,797… more
- Veterans Affairs, Veterans Health Administration (Daytona Beach, FL)
- …The incumbent will serve as a Complex t Patient Aligned Care Team (PACT) Physician located at the Daytona Beach VA Clinic in Daytona Beach, FL assigned to ... currently seeking an outstanding full-time Family Practice or Internal Medicine trained physician with recent experience in VA outpatient PACT panel management to… more
- ChenMed (Jacksonville, FL)
- …explain primary care provider role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... and we need great people to join our team. The Primary Care Physician (PCP) is a licensed/Board Certified/Board Eligible trained professional in internal or family… more
- ChenMed (Jacksonville, FL)
- …and explain nurse practitioner role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... + Recognizes situations which require the immediate attention of a physician , and initiates life-saving procedures when necessary. + Uses advanced communication… more
- Highmark Health (Tallahassee, FL)
- …DOH, and DOL regulations at all times. In addition to utilization review , the incumbent participates as the physician member of the multidisciplinary team ... Inc. **Job Description :** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in… more
- HCA Healthcare (Bradenton, FL)
- …a data-driven environment of quality and cost improvement and develops systems to review utilization of resources and objectively measure outcomes of care in ... for appeals and denials process, discharge planning, case management, and utilization review /management. + Consults with facility-level staff regarding delegated… more