2 administration operations jobs found

Responsibilities About Manatee Memorial Hospital (MMH): Manatee Memorial Hospital® in Bradenton, Florida, has served the citizens of Manatee, Sarasota and surrounding counties for over 70 years and has earned The Joint Commission’s Gold Seal of Approval. The 295-bed hospital with over 800 physicians, residents and allied health professionals, offers advanced healthcare services in a caring and compassionate environment. Services include cardiac care and cardiovascular medicine, emergency care for all ages, surgery services — including robotic-assisted surgery with the da Vinci® Surgical System, a weight–loss program, orthopedic services, outpatient and inpatient radiology and rehabilitation, respiratory care, sleep, oncology, wound care and women’s and children’s services. Manatee Memorial Hospital offers a Level II Neonatal Intensive Care Unit for babies with special needs and has the only Pediatric Center hospital-based outpatient multidisciplinary pediatric...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated. Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions. Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications. Participates in strategic planning for and evaluation of the Care Management The successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Oncology Radiation, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the past 18...