- Humana (Tallahassee, FL)
- …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all… more
- Humana (Tallahassee, FL)
- …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... this knowledge in their daily work. The Medical Director's work includes computer based review of moderately complex to complex clinical scenarios, review of all… more
- Humana (Tallahassee, FL)
- …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all… more
- ChenMed (Tampa, FL)
- …explain primary care provider role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... re: goals of care, palliative care and hospice. + Utilization /Financial Management-managing resource utilization and reimbursement for...quality of health care. + Applies skills in peer review to promote a culture of excellence. + Anticipates… 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 ... utilization , drug spend analysis, and quality improvement activities. Provides...departments are meeting market share goals + Facilitate the review of division ADE/ADR reports to identify trends and… more
- Highmark Health (Tallahassee, FL)
- …business relationships, the impact of Highmark's business decisions on Informatics, personnel utilization , and the use and planning of technology. The role involves ... units that may assist in the resolution of issues or problems. + Access, review , utilize, contribute content to and participate in the maintenance of the shared… more
- Ascension Health (Jacksonville, FL)
- …recent work experience in a hospital setting, preferably with some Physician Advisory/ Utilization Management work experience. If you are ready to join a talented ... group of physicians apply today! **Responsibilities** : + Review medical records of identified patients to assist with the level of care and length of stay… more
- HCA Healthcare (Sanford, FL)
- …is preferred + BSN is preferred + Certification in Case Management, Nursing or Utilization Review is preferred HCA Florida Lake Monroe Hospital is a 221-bed ... supporting a balance of optimal care and appropriate resource utilization . You would be part of a phenomenal team...apply for our RN Case Manager opening. We promptly review all applications. Highly qualified candidates will be directly… more
- Elevance Health (Miami, FL)
- …+ Demonstrate and maintain knowledge of relevant policies and regulations pertaining to utilization review of oncology care. + Participate on committees or in ... and providers. **How you will make an impact:** + Perform physician-level case review , following initial nurse review , of Medical Oncology regimens and… more
- HCA Healthcare (Sun City Center, FL)
- …Healthcare Quality) OR CHCQM (Diploma in American Board of Quality Assurance and Utilization Review Physicians). _Individuals without CPHQ or_ CHCQM _will be ... As our Director, you willprovide direction to ensure the facilitation and utilization of diverse strategies and communication for quality and performance improvement… more