- Actalent (Orlando, FL)
- …claims and preauthorization processing - Responsible for accurate and timely medical review of claims and preauthorization's - Responsible for accurate and timely ... medical review of customer service inquirers about claims and preauthorization's...- Responsible for determining member eligibility prior to medical review - Responsible for fostering a constructive relationship with… more
- AdventHealth (Altamonte Springs, FL)
- …Nursing OR Social Worker: BSW Two (2) years of experience in direct Care Management State specific RN license if a nurse **Preferred qualifications:** Registered ... and 125,000 outpatients each year **The role you'll contribute:** **The Care Management Supervisor is under the general leadership of the Care Management… more
- MyFlorida (Orlando, FL)
- SENIOR REGISTERED NURSE SUPERVISOR Date: Oct 30, 2024 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... Requisition No: 824969 Agency: Veterans Affairs Working Title: SENIOR REGISTERED NURSE SUPERVISOR Pay Plan: Career Service Position Number: 50556018 Salary:… more
- CenterWell (Orlando, FL)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...and reliable transportation. + Two years as a Registered Nurse with at least one-year of management … more
- US Anesthesia Partners (Orlando, FL)
- …comprehensive plans of care for Program patients. + Perform clinical documentation review of each Physician/ Nurse Practitioner per Medical Staff guidelines. + ... seeking a Medical Director for their pre-admission optimization clinics and the Nurse Practitioner services. As a Medical Director, Physician will have varied duties… more
- Veterans Affairs, Veterans Health Administration (Winter Park, FL)
- …coordinated care delivery model. They work with the patient care team to review the clinic utilization by using various reports ensuring the clinic ... - Friday 8:00am to 4:30pm. Subject to change with management discretion to accommodate the needs of the VA...delivery model. Coordinates with the patient care team to review clinic appointment availability ( utilization ) to ensure… more
- HCA Healthcare (Sanford, FL)
- …services and administrative activities including fiscal, material and human resource management . + Maintains and monitors utilization of resources, physical ... policies, equipment, and practices. + Manages staff performance through regular review , real time feedback, and performance planning. Ensures performance reviews are… more
- Adecco US, Inc. (Sanford, FL)
- …(CCM) . Experience or exposure to discharge planning . Experience in utilization review , concurrent review or risk management . Previous experience in a ... . Performing medication reconciliation . Conducting Motivational Interviewing and Self- Management Goal setting . Providing patient education . Creating referrals… more