- ScionHealth - Kindred Cornerstone & Solara Hospitals (St. Petersburg, FL)
- …82 long term acute care beds, we partner with your physician and offer 24-hour clinical care seven days a week so you can start your journey to wellness. Comparably, ... for nursing personnel, manage disciplinary issues, prepare administrative reports, review staffing and budgetary needs, and integrate Nursing Services functions… more
- Centers Plan for Healthy Living (Margate, FL)
- RN - Grievance and Appeals Clinical Reviewer 5297 W Copans Rd, Margate, FL 33063, USA Req #461 Monday, June 3, 2024 Centers Plan for Healthy Living's goal is to ... plans they need for healthy living. JOB SUMMARY: The Grievance & Appeal Clinical Reviewer performs complex medical necessity reviewed on Initial Adverse… more
- Prime Therapeutics (Tallahassee, FL)
- …fuels our passion and drives every decision we make. **Job Posting Title** Physician Clinical Reviewer , MRx - Oncology - REMOTE **Job Description Summary** Key ... clinical determinations cannot be made by the Initial Clinical Reviewer . + Discusses determinations with requesting...as needed to discuss cases and problems. + Utilizes medical/ clinical review guidelines and parameters to assure… more
- Centers Plan for Healthy Living (Margate, FL)
- UM Clinical Reviewer 5297 W Copans Rd, Margate, FL 33063, USA Req #664 Monday, June 3, 2024 Centers Plan for Healthy Living's goal is to create the ultimate ... applications for Full Time Registered Nurse without experience. The Utilization Management Clinical Reviewer works within a multidisciplinary team to help… more
- Evolent Health (Tallahassee, FL)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Physician Clinical Reviewer you will be a key member of the utilization management team. ... Will Be Doing:** + Serve as the Physician match reviewer in Imaging cases, that do not initially meet... rationale for standard and expedited appeals. + Utilizes medical/ clinical review guidelines and parameters to assure… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- Position Purpose: The Clinical Reviewer will be responsible for conducting clinical reviews of medical records during the course of fraud investigations, ... eliminating fraud, waste and abuse. Responsibilities: + Perform the clinical review in Standard Claims Processing System...+ 5 to 7 years of experience as a clinical reviewer and working with ICD-9/10 CM,… more
- Evolent Health (Tallahassee, FL)
- …Stay for the culture. **What You'll Be Doing:** As a Vascular Surgery, Physician Clinical Reviewer you will be a key member of the utilization management ... Will Be Doing:** + Serve as the specialty match reviewer in Vascular Surgery cases, that do not initially... rationale for standard and expedited appeals. + Utilizes medical/ clinical review guidelines and parameters to assure… more
- Cleveland Clinic (Stuart, FL)
- …UM Team Manager to perform UM activities which include admission review , concurrent review , retrospective chart review and clinical systems review to ... away from home. As a Utilization Management (UM) RN Reviewer , you will work under the general supervision of...or visit. Some of your responsibilities include medical record review , providing clinical information to the payer,… more
- Zelis (St. Petersburg, FL)
- …found and justifying the revised choices of new codes and DRG, based on the clinical evidence obtained during the review + Document all aspect of audits ... Job Description Position Overview: The Inpatient DRG Reviewer will be primarily responsible for conducting post-service, pre-payment and post pay comprehensive… more
- Zurich NA (Tallahassee, FL)
- Clinical Bill Review and Treatment Plan Team Manager 113692 Zurich Insurance is seeking a Clinical Bill Review and Treatment Plan Team Manager. This ... position is 100% remote. The Clinical Bill Review and Treatment Plan Team Manager will be responsible for overseeing the team that reviews and evaluates medical… more
- Centers Plan for Healthy Living (Margate, FL)
- Clinical Review RN 5297 W Copans Rd, Margate, FL 33063, USA Req #460 Monday, June 3, 2024 Centers Plan for Healthy Living's goal is to create the ultimate ... plans they need for healthy living. Job Summary: We are currently looking for Clinical Review RN's to join our team. These positions are responsible for the … more
- AmeriHealth Caritas (Palm Beach Gardens, FL)
- …as appropriate. + Assures minimally necessary medical records are collected and organized for clinical review to occur. Summarizes all clinical findings for ... - Clinical is responsible for leading and coordinating the clinical quality review process of member concerns and medical records utilizing standards of… more
- University of Florida (Lake County, FL)
- …projects. + Act as a resource for research staff in the implementation of clinical research protocols and review of study goals and outcomes, providing guidance ... participant recruitment, including human-subject protection, health studies and Institutional Review Boards SKILLS + Clinical -trials management systems and… more
- AdventHealth (Maitland, FL)
- …nurses and clinical documentation specialists. This role will oversee the review processes of complex patients that vary in age and have different developments ... inpatients and 125,000 outpatients each year **The role you'll contribute:** The Clinical Documentation Integrity Manager is a Registered Nurse and/or a Registered… more
- University of Miami (Hialeah, FL)
- …the CDI staff while applying CDI expertise. + Supervises all phases of the clinical documentation process and applies CDI review expertise to ensure compliance, ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Manger of… more
- University of Miami (Miami, FL)
- …and Review * Assist in developing, implementing and maintaining-subject to review and approval of thehospital(s)-the administrative and clinical policies ... teams in collaboration with department, nursing, and hospital administration to review practices and implement clinical practice improvements that result… more
- CenterWell (Orange Park, FL)
- …policies and standards. + Assesses staff education needs based on own the review of clinical documentation in addition to feedback and recommendations by ... caring community and help us put health first** The ** Clinical Manager** coordinates and oversees all direct care patient...Utilization Review staff. Upon completion of the assessment, creates and… more
- J&J Family of Companies (Tallahassee, FL)
- …peers through review of deliverables to minimize delays during the quality review process; + Interface between Clinical R&D, IT and Quality including CSV ... Senior Clinical Data Analyst - 2406185694W **Description** At Johnson...eTMF and other relevant platforms (as assigned); + Create, review and facilitate approval of system deliverables and facilitate… more
- University of Miami (Miami, FL)
- …and safety information and ensure that study team. + Prepare and review with Principal Investigator's clinical agreements/study budgets and informed consent ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Department of… more
- Kelly Services (Tampa, FL)
- **Kelly(R) Science & Clinical ** is seeking a Sub-Investigator for a fulltime, direct-hire position with a research site in Tampa, FL. If you're passionate about ... protocol design, if applicable * Understand the trial design including its clinical , scientific, statistical, and ethical integrity. * Provide protocol feedback to… more
