Current jobs related to physician reviewer - Miami, Florida - The Judge Group Inc.
-
Miami, Florida, United States Jackson Health Full timeDepartment: Jackson Memorial Hospital - Utilization Review Case Management (two openings)Address: 1611 NW 12 Ave, Miami, FL 33136Shift Details: 8:00 am - 4:30 pm, Monday-Friday with weekends occasionally (primarily remote)Why Jackson Memorial Hospital: Jackson Memorial Hospital is the flagship hospital for Jackson Health System and it has been a beacon of...
-
Miami, Florida, United States Baptist Health South Florida Full timeBaptist Health South Florida is the region's largest not-for-profit healthcare organization with 12 hospitals, more than 27,000 employees, 4,000 physicians, and 200 outpatient centers, urgent care facilities, and physician practices spanning across Miami-Dade, Monroe, Broward, and Palm Beach counties. Baptist Health has internationally renowned centers of...
-
Experienced Claims Review Specialist
1 week ago
Miami, Florida, United States PayerFusion Holdings LLC Full timeJob OverviewCompany Overview:PayerFusion Holdings LLC is a premier service organization dedicated to providing exceptional solutions as a licensed Third-Party Administrator. We are looking for talented and knowledgeable professionals who can exceed our clients' expectations. Our firm is committed to innovation, offering a unique experience for healthcare...
-
Experienced Claims Review Specialist
4 days ago
Miami, Florida, United States PayerFusion Holdings LLC Full timeJob OverviewCompany Overview:PayerFusion Holdings LLC is a premier service organization dedicated to providing exceptional solutions as a licensed Third-Party Administrator. We are on the lookout for talented and seasoned professionals who can not only fulfill but exceed the expectations of our clients. Our organization is committed to leading the way in...
-
Physician Assistant
3 months ago
Miami, Florida, United States Department Of Veterans Affairs Full timeSummary This is an OPEN CONTINUOUS ANNOUNCEMENT. Applications will be accepted on an ongoing basis and will remain on file through 12/31/2024. The first cut-off date is 2/21/2024. Eligible applicants will then be referred every 2 weeks until positions are filled. Applications will only be accepted from All qualified U.S. Citizens. Duties As a Licensed...
-
Staff Physician
2 months ago
Miami, Florida, United States UOMUOMUS Full timeCurrent Employees:If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review this tip sheet.The Department of Medicine, Division of Geriatrics and Palliative...
-
Physician Admin Assistant
1 month ago
Miami, Florida, United States Nicklaus Children's Health System Full timeDescription Summary Performs and provides administrative support services such as scheduling appointments, tests, admissions and procedures as needed. Preparing correspondence and manuscripts, scheduling meetings, maintaining records & files, and conducting special projects as assigned by Physician and Leader. Job Specific DutiesAnswers and...
-
Physician (Dermatologist)
3 months ago
Miami, Florida, United States Department Of Veterans Affairs Full timeSummary This is an open continuous announcement that will remain open until filled. Applications will be accepted on an ongoing basis. Eligible applicants will be referred each week for consideration until a selection is made. Duties VA offers a comprehensive total rewards package. VHA Physician Total Rewards.Pay: Competitive salary, annual performance...
-
Staff Physician
1 month ago
Miami, Florida, United States UOMUOMUS Full timeCurrent Employees:If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review this tip sheet.General Description (Purpose and Function):To provide uniform...
-
APRN/ Physicians Assistant
1 month ago
Miami, Florida, United States Mount Sinai Medical Center Full timeAPRN/ Physician Assistant-Neurosurgery As Mount Sinai grows, so does our legacy in high-quality health care. Since 1949, Mount Sinai Medical Center has remained committed to providing access to its diverse community. In delivering an unmatched level of clinical expertise, our medical center is committed to recruiting and training top healthcare workers from...
-
Physician (Diagnostic Radiologist)
3 months ago
Miami, Florida, United States Department Of Veterans Affairs Full timeSummary This is an open continuous announcement that will remain open until filled. Applications will be accepted on an ongoing basis. Eligible applicants will be referred each week for consideration until a selection is made. Duties This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You...
-
UMMG Staff Physician
3 weeks ago
Miami, Florida, United States UOMUOMUS Full timeCurrent Employees:If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review this tip sheet.This is Part Time Staff Physician position in the Department of...
-
UMMG Staff Physician
3 months ago
Miami, Florida, United States UOMUOMUS Full timeCurrent Employees:If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review this tip sheet.CORE JOB SUMMARY The UMMG Staff Physician provides medical care to...
-
Physician (Urologist)
1 month ago
Miami, Florida, United States Department Of Veterans Affairs Full timeSummary This is an open continuous announcement that will remain open until filled. Applications will be accepted on an ongoing basis. Eligible applicants will be referred each week for consideration until a selection is made. Duties This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You...
-
UMMG Staff Physician
2 months ago
Miami, Florida, United States UOMUOMUS Full timeCurrent Employees:If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review this tip sheet.Transforming LivesThe University of Miami is among the top research...
-
Physician and Executive Recruitment Coordinator
1 month ago
Miami, Florida, United States UOMUOMUS Full timeCurrent Employees: If you are currently employed as Staff, Faculty, or in a Temporary role at the University of Miami, please log in to Workday to access the internal application process. Review the tip sheet to understand how to apply for faculty or staff positions using the Career worklet. The Office of Physician and Executive Recruitment in Miami, FL is...
-
Physician (Cardiothoracic Surgery)
2 months ago
Miami, Florida, United States Veterans Health Administration Full timeThis position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific individual eligibility requirements in accordance with VHA policy and submit your EDRP application within four months of appointment. Program Approval, award amount (up to $200,000) and eligibility period (one to...
-
Physician (Geriatrics) Service Chief
2 months ago
Miami, Florida, United States Veterans Health Administration Full timeThis is a joint recruitment between the Miami VA Healthcare System and Florida International University and is offering a generous start-up package from FIU; and there will be funds available for the recruitment of talented faculty to fulfill the educational and research needs of both Centers. The Miami VA Healthcare System's and the Geriatric, Research,...
-
Per Diem Staff Physician
3 months ago
Miami, Florida, United States UOMUOMUS Full timeCurrent Employees:If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review this tip sheet.Transforming LivesThe University of Miami is among the top research...
-
Per Diem Staff Physician
3 months ago
Miami, Florida, United States UOMUOMUS Full timeCurrent Employees:If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review this tip sheet.Transforming LivesThe University of Miami is among the top research...
physician reviewer
2 months ago
Salary: $95.00 USD Hourly - $105.00 USD Hourly
Description: Our client is currently seeking a PHYSICIAN REVIEWER (REMOTE)
Can work in any state (part-time)
This position requires an initial time commitment to undergo and complete training.
After training, physician medical reviewer will provide weekend coverage, 8 hour shifts per Saturday and Sunday per month.
This job will have the following responsibilities:
- Evaluates clinical service requests made by an organization's members and providers.
- Uses clinical judgment in conjunction with organization's criteria to adjudicate these requests.
- May also provide clinical leadership in other areas of the organization.
- Identifies opportunities to manage members' clinical situations with a view toward creative problem solving and anticipation of possible future clinical problems for the member.
- Participates in the process to evaluate clinical service requests.
- Practices anticipatory case management for members whose cases come for review, in partnership with case managers.
- Participates in the Physician Review Units' appeal process of service denials.
- Participates in the development of Physician Review Units' policies and procedures.
- Actively participates in all unit continuous quality improvement activities. Other duties as assigned by the Medical Director.
- Must be board Certified, M.D. or D.O with an unrestricted physician license in a state or territory of the United States.
- 5 years clinical experience to include inpatient experience, or any combination of education/experience that would provide an equivalent background.
- Must understand managed care and demonstrate PC proficiency, as file review will be done via computer in most cases.
- (Note: Position does not provide direct patient care or medical diagnosis.)
This job and many more are available through The Judge Group. Find us on the web at
