Career Opportunities in Florida
eQHealth Solutions implements a comprehensive Medicaid utilization management program for the state of Florida with offices located in the Tampa and Miami/Dade areas. The program is designed to prevent unnecessary or inappropriate use of services, protect against excess payments and assess the quality of health care services provided to Medicaid recipients.
To apply for any of these positions, please send your resume to:
or fax to: (813) 448-1897
Equal Opportunity Employer
Clinical Letters Specialist
eQHealth Solutions, a Medicaid utilization review and quality improvement organization has an excellent opportunity for a Registered Licensed Practical Nurse with unrestricted license in the state of Florida. This person will prepare letters describing clinical rationale for adverse determinations for review by Medical Director (and/or their designee). Researches specific cases to evaluate completeness of documentation and refers incomplete case for additional medical review.
Successful candidate will have a minimum two years experience summarizing clinical determinations in a Utilization Management and/or Quality Assurance Program and experience working with the Medicaid population. Clinical experience required (Pediatrics preferred). Must have excellent verbal and written communicate skills and the ability to prioritize and manage a high volume of cases. Intermediate working knowledge of MS Office Suite, including Word and Outlook and familiarity with InterQual and Milliman & Robertson Health Care Criteria required.
Position located near the Tampa Airport. Excellent benefit package. Send salary requirements with resume.
Pediatric Care Coordination RN
eQHealth Solutions, Inc., a leading healthcare quality improvement and utilization review organization, has an excellent opportunity for Registered Nurses. This position will be responsible for case management of medically complex situations involving children and their families. Will be responsible to oversee the coordination and approval of private duty nursing services in the home and will determine the objectives and goals to ensure adequate coverage authorization within the mandated Medicaid guidelines and criteria. Evaluates and modifies the plan of care as needed. Regularly communicates changes to the family, healthcare team, and other agencies involved. Maintains system for tracking all incoming and outgoing correspondence in accordance with timelines and requirements. BSN preferred.
The successful candidate will have an active, unrestricted Florida registered nurse license with a minimum of 2 years relevant experience in pediatrics. At least 6-12 months experience in home health and some case management experience strongly preferred. Successful candidate will be able to work independently, be proficient with Microsoft Office products and have the ability to prioritize and meet timelines. Interactions with families may require evening or weekend commitments. Occasional overnight travel may be required.
eQHealth Solutions seeks a Software Developer to be involved in the full lifecycle development of healthcare applications including software analysis, code analysis, requirements analysis, software review, identification of code metrics, system risk analysis and software reliability analysis. Duties include:
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under contract 500-99-LA02
with the Centers for Medicare & Medicaid Services (CMS). The contents presented do not necessarily reflect CMS policy.
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