- AdventHealth (Maitland, FL)
- …need.Collaborates with Senior Medical Officers with contracted managed care payers regarding utilization review management activities and maintain a positive and ... & Indicators. Works in close coordination with the processes of the Utilization Review Management staff for continual process improvement and reporting.Reviews… more
- CenterWell (Kissimmee, FL)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... and documentation requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance review … more
- Community Based Care of Brevard, Inc. (Brevard, FL)
- …sources whenever possible. This position facilitates Standing Team Reviews and monthly utilization review process, receives, reviews, and provides bypass service ... Position Summary: This position is responsible for the clinical coordination, utilization management and authorization of initial and ongoing services for children… more
- AdventHealth (Altamonte Springs, FL)
- …to nurses, physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge Planning and care ... Data analysis skills Current working knowledge of discharge planning, utilization management, care management, performance improvement and managed care reimbursement… 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 ... and patient throughput while supporting a balance of optimal care and appropriate resource utilization . You would be part of a phenomenal team that works hard to… more
- Universal Health Services (Orlando, FL)
- …Position Summary The Utilization Review ... + Three (3) to five (5) years' experience in chart analysis and utilization review in the psychiatric and chemical dependency filed preferred. + Valid FL… more
- Health First (Brevard County, FL)
- …effectiveness, fiscal and program/service efficiency. 5. Address and support workforce utilization efforts to achieve staffing standards, including review of ... line policies to maximize revenue, along with the efficient and effective utilization of finance and human resources. *PRIMARY ACCOUNTABILITIES* 1. Supervise Retail… more
- Burns & McDonnell (Orlando, FL)
- …the repository updated + Align Security Compliance team with 1898 CX Principals + Review utilization and assignment of projects -ensuring proper utilization ... excellence and innovation within the Security Compliance Team. + Approve and review Governance and Compliance methodologies and tools, ensuring their suitability for… more
- AdventHealth (Maitland, FL)
- …quality control/timeliness of reporting + Extracts, collects, analyzes and interprets health utilization and financial data of various types + Interpret an analyze ... and effectively present analytics or project results to key stakeholders for review and decision-making + Evaluate and understand contract language as it relates… more
- AdventHealth (Tavares, FL)
- …to nurses, physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge Planning and care ... (as permitted by the patient) as well as a review of the current and past inpatient and outpatient...days, and facilitates progression of care. . Collaborates with Utilization Management staff for collaboration on patient status changes… more
- AdventHealth (Orlando, FL)
- …to nurses, physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge Planning and care ... givers (as permitted by thepatient) as well as a review of the current and past inpatient and outpatient...+ Health-related Master's degree or MSN + Prior Care Management/ Utilization Management experience + ACM/CCM Certification + Knowledge of… more
- AdventHealth (Orlando, FL)
- …to nurses, physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge Planning and care ... and updates, as needed. + Actively participates in daily Multidisciplinary Rounds to review progression of care and discharge plan for all assigned patients. +… more
- MyFlorida (Orlando, FL)
- …+ Attains a high proficiency/skill level as demonstrated through the competent utilization of the program's hardware, software, system applications and web pages. + ... as assigned by the supervisor. + Knowledge, skills and abilities, including utilization of equipment, required for the position: Knowledge of theories and practice… more
- American Homes 4 Rent (Orlando, FL)
- …access to vendor accounts, reviewing of pricing structure adherence, review system/process compliance utilization , conducts quality assurance inspections ... + Partners with District Maintenance Managers with internal audits to ensure proper utilization of vendors and allocation of work to maximize service levels and… more
- AssistRx (Orlando, FL)
- …assigned project managers + Ensures PM utilize scope management practices + Review and/or approve Status Reports, Project Schedules, Financial Summaries, etc + ... transition to operations + Drive to business outcomes & utilization , not just deadlines + Drives adherence to IT...Functions as a Working Team Leader + Forecast resource utilization and capacity to achieve optimal staffing ratios and… more
- NBC Universal (Orlando, FL)
- …efficiencies in theme park operations and establish methods for maximizing utilization of facilities and personnel. Direct multiple, concurrent complex projects, ... that minimize overall labor costs and improve team member utilization . Establish baseline historical performance, seasonality, transaction volume, revenue,… more
- Zimmer Biomet (Orlando, FL)
- …including surgeons, staff , executives and local implant teams to drive system utilization with the ROSA (TM) Robotic Knee Platform **How You'll Create Impact** + ... Drives system utilization by determining the appropriate program elements to meet...the local market + During periodic ROSA (TM) Program Review meetings with hospital administration and surgeons, provide relevant… more
- Elevance Health (Altamonte Springs, FL)
- …care for wound care. + Promotes healing and decrease home care utilization . + Responsible for certification determinations and sending written authorizations to ... Refers requests that do not meet coverage guidelines criteria to Physician for review . + Uses clinical judgment in authorizations that fall outside of guideline… more
- AdventHealth (Altamonte Springs, FL)
- …safety, and quality outcomes. The Physician Advisor is responsible for providing clinical review of utilization , , and quality assurance related to inpatient ... clinical practice experience **_EXPERIENCE PREFERRED_** _:_ .Understanding of hospital Utilization Management/Medicare Regulations .Two years or greater experience as… more
- Insight Global (Kissimmee, FL)
- …collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ . ... system Extensive understanding of metric creation through Smartsheet through the utilization of Dashboards and advanced formula creation Extensive understanding of… more