Medicaid Clinical Review jobs in Palm Harbor, FL

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Education Specialist
eQHealth Solutions - Tampa, FL
Three (3) years of clinical experience or combination of clinical experience and utilization review experience....
Sponsored by eQHealth Solutions - 1 day ago
Manager, Accreditation & Quality Management
eQHealth Solutions - Tampa, FL
Sound decision-making skills for clinical and non-clinical issues. Responsible to prepare for Accreditation onsite review and complete necessary documentation....
Sponsored by eQHealth Solutions - 1 day ago

Education Specialist

eQHealth Solutions - Tampa, FL
Three (3) years of clinical experience or combination of clinical experience and utilization review experience....

RAC COORDINATOR

BayCare Health - Clearwater, FL
The RAC Coordinator is responsible for coordinating all aspects of the RAC program request, appeals, etc. The RAC Coordinator will interact with administrative...

Inpatient Review Nurse - RN (Commercial)

eQHealth Solutions - Tampa, FL
Prospective Review Urgent/ Non-urgent, Concurrent Review and Retrospective Review. Accurately enters all review information data, clearly documenting the review...

Behavioral Health Liaison

IASIS Integrated Care Solutions - Tampa, FL
Request and review medical records. Knowledge of Medicaid and/or Medicare guidelines and regulations preferred....

Registered Nurse

Lancesoft Inc - Saint Petersburg, FL 33716
Please review the Job description below.  Prior clinical experience preferably in maternal-child care, obstetrical office, obstetrical floor in an acute care...
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HEDIS Nurse

Anthem, Inc. 583 reviews - Tampa, FL
Prepares cases for Peer Review Committee. BA/BS in Nursing, Health Administration or a related clinical field;...

Manager, UM Operations

eQHealth Solutions - Tampa, FL
Five years of clinical experience or combination of clinical experience and utilization review experience....

Tampa, FL - Field Access Specialist

inVentiv Health 126 reviews - Tampa, FL
Pharmaceutical industry in managed care, clinical support, or sales. Ability to review clinical information in patient charts, understand and interpret payer...

Psychiatry Therapeutic Specialist

Sunovion - Saint Petersburg, FL
Proficient knowledge and understanding of the payer landscape including commercial, Medicaid, and Medicare. Candidates must provide two most immediate years of...

Senior Training Specialist - Clinical Systems

WellCare 114 reviews - Tampa, FL
Mgr, Clinical Systems. Preferred Other Experience with Government Programs, Medicare and Medicaid. Trains, facilitates and assesses training programs for the...
Manager, UM Operations
eQHealth Solutions - Tampa, FL
Five years of clinical experience or combination of clinical experience and utilization review experience....
Sponsored by eQHealth Solutions - 1 day ago
Director, Project Implementation and Quality
eQHealth Solutions - Tampa, FL
Experience with RFP review and response preferred. Five (5) years experience in a clinical nursing role. Medicaid, Commercial and/or managed care quality and/or...
Sponsored by eQHealth Solutions - 23 days ago
Inpatient Review Nurse - RN (Commercial)
eQHealth Solutions - Tampa, FL
Prospective Review Urgent/ Non-urgent, Concurrent Review and Retrospective Review. Accurately enters all review information data, clearly documenting the review...
Sponsored by eQHealth Solutions - 23 days ago

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Company with Medicaid Clinical Review jobs
eQHealth Solutions is a non-profit, multi-state medical management company that provides a wide range of solutions to our clients.