VP Medical Review - Tampa, FL

The Medical Reviewer/Safety Reviewer II provides timely assessment of reported clinical trial data and participates in applicable safety surveillance activities for assigned studies. · Degree- BSN · ...

Provides timely assessment of reported clinical trial data and participates in applicable safety surveillance activities for assigned studies including review of labs, vital signs, cardiac, medications, medical history. · ...

The Vice President, Medical Review Services is responsible for the overall operation of a designated bill review office. The Manager participates in formulating and administering company best practices as well as developing long-range goals and objectives, analyzing costs manages ...

Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Contributes to overarching strategy to provide ...

We're simplifying the health care experience, creating healthier communities and removing barriers to quality care. · ...

Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. · ...

Summary · A registered pharmacy technician is someone other than a licensed pharmacist or pharmacy intern that performs pharmacy tasks and duties as delegated by a licensed pharmacist that do not fall within the purview of Florida Statue All such delegated acts will be performed ...

We are seeking a dedicated Medical Director in Tampa, FL to oversee clinical operations and ensure quality patient care. · Provide clinical leadership and strategic direction for medical services. · Develop, review, and implement policies and protocols to maintain compliance and ...

The Oncology Pharmacy Technician Coordinator will complete tasks and duties that include but are not limited to: initiating or receiving communications with patient provider team members to facilitate patient care. · Assist in keeping pharmacy operations compliant with local, sta ...

A registered pharmacy technician performs delegated tasks and duties under the direct supervision of a licensed pharmacist. They assist in patient care, process prescriptions, and maintain records. · ...

Company Description · CASE HEALTH AI (CHAI) specializes in creating AI-driven solutions that automate administrative tasks for health plans, with a focus on prior authorizations. Our advanced AI tools analyze faxes, clinical documents, and guidelines to deliver accurate, explaina ...

Summary · Job Summary: · A registered pharmacy technician is someone other than a licensed pharmacist or pharmacy intern that performs pharmacy tasks and duties as delegated by a licensed pharmacist that do not fall within the purview of Florida Statue All such delegated acts wil ...

The clinical pharmacist role ensures the injured workers are receiving the right care through appropriate clinical intervention method. · Assessing prescription appropriateness by reviewing patient medical history, drug interactions and potential adverse effects to identify poten ...

Summary · Summary: · The pharmacy business technician coordinator will assist the department with business needs such as monetary collections, deposits, invoicing, reconciliation of pharmacy claims, and auditing. The team members will also work with the patient assistances pharma ...

The · manager will manage the day-to-day operations of the preservice review process for prior authorizations while collaboratively partnering and clinically supporting Avalon's medical director leadership within the clinical review space, · to drive consistent, efficient, and c ...

A Medical Coder reviews adjudicated medical claims that have been denied for reconsideration following company-specific reimbursement policies. · Reviews coding accuracy and medical records details to determine if denial reasons are valid or payment reconsideration warranted. · A ...

The MID REVENUE CYCLE CODING EDUCATOR SR serves as the subject-matter expert and educational resource for any medical record coding and patient charge related issues. · ...

The Utilization Review Case Manager validates the patient's placement to be at the most appropriate level of care based on nationally accepted admission criteria. · The UR Case Manager secures authorization for the patient's clinical services through timely collaboration and comm ...

This position is responsible for obtaining pre-certifications and pre-authorizations for procedures and medications, scheduling appointments for outpatient testing with other providers, transcribes and triages patient calls to physicians, coordinates patient appointments/orders. ...