- Highmark Health (Tallahassee, FL)
- …of the claim rejection and the proper action to complete the retrospective claim review with the goal of proper and timely payment to provider and member ... Payment Integrity strategies on a pre-payment and retrospective claims review basis. Review process includes a ...data to assure appropriate level of payment and resource utilization . It is also used to identify issues which… more
- CenterWell (Daytona Beach, FL)
- …performance in patient experience, quality of care, clinical outcomes, and avoidable utilization *Periodically review clinician charts to identify ... and operational budgeting, and monitor clinical & financial performance and metrics. * Review clinician schedules and incentive plans to align with patient… more
- CenterWell (Jacksonville, FL)
- …clinical performance in patient experience, quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify ... of health (SDOH) efforts, improving clinical outcomes and avoidable utilization + Monitor and manage daily patient care and...and monitor clinical & financial performance and metrics. + Review clinician schedules and incentive plans to… more