Review Management Jobs in Florida (NOW HIRING)

Responsibilities The Utilization Review Director is responsible for directing and overseeing the Utilization Management Department. This includes the implementation of case management scenarios ...

... Management, HEDIS, Chart Auditing, Medical Record Reviews] Additional Information Shift: Monday - Friday 8:00am - 5:00pm This is an immediate contract opening! Pay range $29.00 - $30.00/hr), salary ...

The CRN builds relationships with facility case managers to facilitate appropriate care and ... Participate in weekly case review * Determine member's discharge status and identify and coordinate ...

In this role you will focus on reviewing issues that are identified by management, second line of defense, and third line of defense. Responsibilities include verifying the adequacy of the issues ...

In this role you will focus on reviewing issues that are identified by management, second line of defense, and third line of defense. Responsibilities include verifying the adequacy of the issues ...

Summary: Coordinates the day-to-day activities of the Institutional Review Board (IRB) office, including review of research protocols for regulatory compliance, protocol review management, and ...

... review management

Performs utilization review and management, including quality review, case review for third party payers' requirements. Ensures optimal reimbursement from governmental third-party payers', obtaining ...

Coordinates on-site review of medical records with reviewers from third party payers. * Documents, updates, and manages patient and provider information using internal electronic records system.

Coordinates on-site review of medical records with reviewers from third party payers. * Documents, updates, and manages patient and provider information using internal electronic records system.

Coordinates on-site review of medical records with reviewers from third party payers. * Documents, updates, and manages patient and provider information using internal electronic records system.

This is achieved through the review of inpatient admissions, outpatient precertification, and prior authorization requests, using established medical policies, evidence-based guidelines, and managed ...

Completes Concurrent Reviews as required by payor sources, case management company or other intermediary entity to ensure ongoing communication and preauthorization of services. This level of review ...

This is achieved through the review of inpatient admissions, outpatient precertification, and prior authorization requests, using established medical policies, evidence-based guidelines, and managed ...

This is achieved through the review of inpatient admissions, outpatient precertification, and prior authorization requests, using established medical policies, evidence-based guidelines, and managed ...

This is achieved through the review of inpatient admissions, outpatient precertification, and prior authorization requests, using established medical policies, evidence-based guidelines, and managed ...

Revenue Cycle Management : Utilize clinical expertise to support revenue cycle processes, including ... Utilization Review: a) Apply medical necessity screening criteria and clinical knowledge to ensure ...

In this remote role, you'll manage a caseload of 50-75 patients, conducting admission and continuing-stay reviews, coordinating authorizations, and serving as a key liaison between Banyan's clinical ...

Receive and review escalated reviews. * Conduct timely peer-to-peer discussions with treating ... Experience with care management within the health insurance industry. * Willing and able to obtain ...

This is achieved through the review of inpatient admissions, outpatient precertification, and prior authorization requests, using established medical policies, evidence-based guidelines, and managed ...