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About Us: · Upperline Health is one of the nation s largest specialty physician practices providing comprehensive care. Founded in 2017 with the ambitious goal of changing specialty care, we deliver a more coordinated approach for patients with chronic and complex conditions by i ...
Daytona Beach $170,000 - $260,000 (USD) per year4 days ago
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Daytona Beach, Florida, Utilization Review Physician Opening - Remote Position · Do you know someone that might be a good fit for this position? Please ask about our generous referral fees · Overview: A large multi-specialty staff model HMO, is seeking a Utilization Management Ph ...
Daytona Beach $170,000 - $260,000 (USD) per year4 days ago
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Join a dynamic team at The Provider Finder as a Family Practice Physician. · About the Role · This opportunity is part of our partnership with a large multi-specialty HMO in Volusia County. We are seeking an experienced or newly graduated Primary Care Physician to work at one of ...
Daytona Beach $170,000 - $260,000 (USD) per year1 day ago
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Thriving Opportunity in Family Medicine · About the Role · We seek a dedicated Board Certified or Eligible Family Medicine Physician to join our esteemed practice. As part of a well-established team, you will have the chance to make a meaningful impact while enjoying an exception ...
Daytona Beach $170,000 - $260,000 (USD) per year1 day ago
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Outpatient Family Medicine opportunity in Coastal Florida Join a local Health System minutes from the beach searching for another FM to join their large multi-specialty group. Experienced physicians are preferred. with no state income tax in Florida, you will have a chance to max ...
Daytona Beach $170,000 - $260,000 (USD) per year1 week ago
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Outpatient Family Medicine opportunity in Coastal Florida Join a local Health System minutes from the beach searching for another FM to join their large multi-specialty group. Experienced physicians are preferred. with no state income tax in Florida, you will have a chance to max ...
Daytona Beach $2,000,000 (USD) per year5 days ago
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Daytona Beach, Florida, Utilization Review Physician Opening - Remote Position · Do you know someone that might be a good fit for this position? Please ask about our generous referral fees · Overview: A large multi-specialty staff model HMO, is seeking a Utilization Management Ph ...
Daytona Beach $170,000 - $260,000 (USD) per year4 days ago
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Family Practice option in affluent Daytona Beach, FL area suburb · Seeking full time physician that wants a long-term career · Must have stable work history demonstrating desire to stay in one area and build and maintain patient panel. · Willing to focus on prevention and quality ...
Daytona Beach $170,000 - $260,000 (USD) per year20 hours ago
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A large multi-specialty staff model HMO, is seeking a Utilization Management Physician (UMP). This full-time, remote position requires critical thinking skills, effective communication, and decisive judgement. · The ideal candidate will have a working knowledge of the responsibil ...
Daytona Beach $170,000 - $260,000 (USD) per year2 days ago
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NEW · Best location in Daytona · Right by the water · SIGN ON BONUS · 4 day work week · Fantastic Salary · RELOCATION ASSISTANCE · Expanding organization seeking full-time Primary Care Physician for their Daytona Beach FL location · NO CALL · NO WEEKEND · NO NIGHTS · NO HOLIDAYS ...
Daytona Beach $170,000 - $260,000 (USD) per year1 week ago
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Seeking a Temp to Perm Family Practice Physician in Daytona Beach, FL. · Provide comprehensive primary care services to diverse patient populations. · Conduct patient evaluations, diagnose illnesses, and develop treatment plans. · Perform routine check-ups, immunizations, and hea ...
Daytona Beach $180,000 - $260,000 (USD) per year2 days ago
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Family Practice Opportunity with the-provider-finder · About the Job · Clinic located in Ormond Beach, Volusia County. · Position Details: · Type: Outpatient only · Patient load: 18-20 patients per day · Work schedule: Flexible 40-hour work week · (Required) · =<UL ITEM=MD / DO < ...
Ormond Beach $400,000 - $500,000 (USD) per year1 day ago
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Family Practice Opening in Ormond Beach, Florida · Private Primary Care Group looking for experienced physician focused on delivering exceptional care The hiring clinic is located in Volusia County, Florida and is seeking to replace a high caliber physician. Physician will have t ...
Ormond Beach $170,000 - $260,000 (USD) per year20 hours ago
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Make a difference in the lives of seniors: · Join our Senior Primary Care Office in · Ormond Beach · , · Florida. · Conviva Senior Care Centers, · a subsidiary of Humana Inc., is seeking a Family, Internal, or Geriatric Medicine Physician to join our growing team in this establis ...
Ormond Beach $240,000 - $300,000 (USD) per year5 days ago
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Job · Description · A large multi-specialty staff model HMO is seeking a BC/BE, Internal Medicine / Family Medicine / Primary Care Physician to join one of our Ormond Beach facilities. · Office hours are flexible, outpatient only, no weekends, call is 1 in 3 and very limited. Thi ...
Ormond Beach $170,000 - $260,000 (USD) per year12 hours ago
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We negotiate better pay and deposit it weekly · We arrange complimentary housing and travel and comprehensive malpractice coverage · We simplify the credentialing and privileging process · Access to online portal for assignment details and time entry · ...
South Daytona1 month ago
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Adult Medicine Physician New Smyrna Beach · Adult Medicine Physician Needed in New Smyrna Beach, Florida · Integrity Placement Group is inviting you to apply to a position in New Smyrna Beach, Fl. New Smyrna Beach combines small-town charm with beautiful Atlantic beaches, offerin ...
New Smyrna Beach $170,000 - $260,000 (USD) per year1 week ago
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AdventHealth Primary Care Network is seeking a Family or Internal Medicine Physician to join our Team in Palm Coast, Florida · Why join AdventHealth Primary Care Network? · • Guaranteed Base Salary plus generous Production Incentive · • Excellent annual compensation of $250,000 a ...
Palm Coast $170,000 - $260,000 (USD) per year12 hours ago
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· Large HMO in sunny Daytona Beach, Florida is eager to talk to Family Medicine physicians regarding multiple needs in the surrounding suburb of Palm Coast, FL. · Opportunity Details · Large Florida HMO looking for Family Medicine physician · Need is outpatient but does require ...
Palm Coast $170,000 - $260,000 (USD) per year1 week ago
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· Large HMO in sunny Daytona Beach, Florida is eager to talk to Family Medicine physicians regarding multiple needs in the surrounding suburb of Debary, FL. · Opportunity Details · Large Florida HMO looking for Family Medicine physician · Need is outpatient but does require roun ...
Debary $150,000 - $200,000 (USD) per year1 day ago
Family Practice - Daytona Beach - Curative
Description
A large multi-specialty staff model HMO, is seeking a Utilization Management Physician (UMP). This full-time, remote position requires critical thinking skills, effective communication, and decisive judgement.The ideal candidate will have a working knowledge of the responsibilities listed:
Review pre-authorization requests, initial clinical review, and concurrent clinical review cases. Review post-service clinical decisions, including claims and appeals
Render determinations based on relevant clinical information, medical necessity determined by using evidence-based medicine, nationally recognized criteria (i.e. MCG (formally Milliman), InterQual, Centers for Medicare and Medicaid), FHCP Protocols, and the Member's FHCP Coverage Documents
Review clinical criteria and scripts at least annually and update if necessary
Assist the CMO in Provider education regarding treatment protocols, treatment options, etc., as appropriate
Be available to staff to answer questions regarding cases under review
Be available for peer-to-peer discussions of cases under initial or concurrent review either in person, by telephone, or electronically
Meet current regulatory standards regarding pre-authorization determinations
Be available to discuss urgent cases directly with attending provider
For non-certification decisions, specifies the principal reason for the determination not to certify and the clinical rationale for the non-certification
Consult with other physicians in medical specialty areas as needed
Participate in committees at the request of the CMO
Practitioner Requirements Practitioner must meet the following minimum requirements to serve as a Utilization Management Practitioner("UMP) for FHCP:
MD, DO, or from an accredited medical school
Licensed to practice medicine in the state of Florida without restriction
Board certified
Have three (3) to five (5) years of clinical experience in utilization review
Knowledge and experience with managed care health plan and benefits
Ability to provide medical knowledge to facilitate resolution of complex issues and required decisions
Working knowledge of medical policy and application of criteria
Agree to participate in the Interrater Reliability Tool or such other audit process to ensure consistent application of medical policy and coverage criteria
Additional Benefits:
Competitive salary
Bonus opportunity
401(K) Tax Deferred Plan
HMO Health Benefits for provider & eligible dependents
Group Term Life
Group Disability
Malpractice Insurance
Paid Leave Time
CME Stipend
Licenses, Fees & Dues reimbursed
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