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Last updated: 7 days ago
Physician Advisor - Centralized Utilization Review - FT Days - MHS

Physician Advisor - Centralized Utilization Review - FT Days - MHS

Memorial Healthcare SystemHollywood, FL
Full-time
PHYSICIAN ADVISOR - CENTRALIZED UTILIZATION REVIEW - FT DAYS - MHS.Ensures documentation, data capture and opportunities for utilization are compliant, accurate and consistent.Makes decisions on re...Show moreLast updated: 30+ days ago
Care Review Clinician I

Care Review Clinician I

Saviance TechnologiesFlorida, US
Full-time
Works with the Utilization Management team primarily responsible for inpatient medical necessity / utilization review and other utilization management activities aimed at providing members with the r...Show moreLast updated: 30+ days ago
Director-Servicing Communications Review & Governance

Director-Servicing Communications Review & Governance

American ExpressSunrise, Florida, United States
Full-time
At American Express, our culture is built on a 175-year history of innovation, shared values and Leadership Behaviors, and an unwavering commitment to back our customers, communities, and colleague...Show moreLast updated: 13 days ago
  • Promoted
Travel Nurse RN - Case Manager, Utilization Review - $1,970 per week

Travel Nurse RN - Case Manager, Utilization Review - $1,970 per week

Medical SolutionsMargate, FL, USA
Full-time
Travel Nurse RN - Case Manager, Utilization Review - $1,970 per week at Medical Solutions summary : .A Travel Nurse RN specializing in Utilization Review, responsible for managing patient care and en...Show moreLast updated: 30+ days ago
Document Report Specialist

Document Report Specialist

All American Document Services LLCFort Lauderdale, FL, US
Full-time
You will work with Researchers and other document support staff in handling FL, NC courts and other jurisdictions to prepare client search reports. utilizing word processing and quick books for inv...Show moreLast updated: 30+ days ago
  • Promoted
Travel Nurse RN - Utilization Review - $2,268 per week

Travel Nurse RN - Utilization Review - $2,268 per week

Nurse FirstMargate, FL, USA
Full-time
Travel Nurse RN - Utilization Review - $2,268 per week at Nurse First summary : .A Travel Nurse RN specializing in Utilization Review is needed for a 13-week assignment in Margate, Florida, offering ...Show moreLast updated: 18 days ago
  • Promoted
Campus Ambassador

Campus Ambassador

The Princeton ReviewDavie, FL, United States
Full-time
As a Campus Ambassador for The Princeton Review, you won’t just represent our brand — you’ll directly influence enrollment and revenue growth by connecting students with the resources they need to ...Show moreLast updated: 7 days ago
  • Promoted
Utilization Review Specialist - FT

Utilization Review Specialist - FT

Mental Health Treatment Centers of AmericaLauderdale Lakes, FL, United States
Full-time
We are Mental Health Treatment Centers of America (MHTCA), the parent company to mental health treatment facilities serving adults and teenagers with primary mental health disorders.Come join us as...Show moreLast updated: 14 days ago
Loan Review Senior Consultant

Loan Review Senior Consultant

CroweFort Lauderdale FL US
Full-time
Crowe is seeking a Loan Review Senior Consultant to perform credit risk consulting projects for a variety of clients in the financial services industry. Provide loan review services and other consul...Show moreLast updated: 30+ days ago
  • Promoted
Legal Assistant - On Site (186)

Legal Assistant - On Site (186)

De Novo Review IncFort Lauderdale, FL, United States
Full-time
A Florida stablished law firm is seeking experienced Insurance Defense Legal Assistant for its Ft.Applicants should have 2+ years of experience, be a self-starter, have excellent communication skil...Show moreLast updated: 15 days ago
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Physician Advisor - Centralized Utilization Review - FT Days - MHS

Physician Advisor - Centralized Utilization Review - FT Days - MHS

Memorial Healthcare SystemHollywood, FL
30+ days ago
Job type
  • Full-time
Job description

PHYSICIAN ADVISOR - CENTRALIZED UTILIZATION REVIEW - FT DAYS - MHS

  • Location : Hollywood, FL
  • Specialty : Physician Advisor
  • Job Number : FY26 01

Summary :

Ensures documentation, data capture and opportunities for utilization are compliant, accurate and consistent.

Responsibilities :

Makes decisions on referred individual patient cases regarding : Pre-admission, authorization, Medical necessity and services / setting, transfers, appropriateness of admission, and continued stay. Conducts peer to peer discussions with health plans when required.Works in collaboration with the Medical Director of Centralized UR / HIM, utilization committees and medical staff to maintain and improve utilization and documentation efforts.Performs regular, follow-up and focused chart audits / reviews (concurrent and retrospective) for the purpose of assessing the accuracy of clinical documentation and utilization. Ability to work weekends and holidays as needed.Serves as a resource to the medical staff for Utilization Review activities. Educates and communicates to the Medical staff the benefits / need for utilization review and documentation.

Competencies :

Education and Certification Requirements :

Medical Doctor (Required)Medical Doctor License (ME LICENSE) - State of Florida (FL), Osteopathic Physician License (OS LICENSE) - State of Florida (FL)

Additional Job Information :

Complexity of Work : Requires critical thinking skills, effective communication, decisive judgment and the ability to work with minimal supervision. The incumbent must be able to work in a stressful environment and take appropriate action when required.

Required Work Experience : Minimum of 1 year of work experience in a clinical setting

Other Information : Prior experience in Utilization Management with hospital system or health system preferredAdditional Education Info : Graduate of a medical school approved by the Council on Medical Education of the American Medical Association.

About Memorial Healthcare System

Since its inception in , Memorial Healthcare System has been a leader in providing high-quality healthcare services to South Florida residents. Moving health forward to meet the needs of the community, Memorial is one of the largest public healthcare systems in the nation and highly regarded for its exceptional patient- and family-centered care that creates the Memorial experience. Memorial's patient, physician and employee satisfaction rates are some of the most admired in the country, and the system is recognized as a national leader in quality healthcare.

is the flagship facility of the healthcare system and is one of the largest hospitals in Florida. Memorial Regional Hospital offers extensive and diverse health care services that include featuring renowned surgeons, treating more inpatients than any other in Broward County, and providing innovative technology and world-class physicians. Memorial Regional Hospital and are both located in Hollywood, Florida, and offer our community a variety of medical and surgical services. at Memorial provides a comprehensive array of pediatric services and is the leading children's hospital in Broward and Palm Beach counties. , and serve the communities of western Broward County and others in South Florida. Memorial Home Health Services, nursing home and a variety of ancillary healthcare facilities round out the system's wide-ranging health services.

About South Florida

South Florida combines Miami-Dade, Broward, and Palm Beach counties, as well as the Florida Keys in Monroe County, with beautiful beaches, museums, wildlife, and sunshine all year round. The area offers a dynamic lifestyle with an abundance of cultural and recreational amenities, including top-rated golf courses, historic art communities, zoos and wildlife refuges, and world-class restaurants. South Florida is home to some of the biggest championship-winning sports teams, the Florida Panthers, Miami Heat, Miami Dolphins, and Miami Marlins, with games hosted in several of South Floridas premier stadiums. Florida residents enjoy beautiful weather year-round and benefit from no state income tax attracting new residents from all over the country and around the world.