Career Opportunities in Florida

eQHealth Solutions is implementing 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:

resumes@eQHS.org
or fax to:   (225) 248-7829
Equal Opportunity Employer

Health Care Provider Education and Outreach Representative(s)

eQHealth Solutions-FL Division, a Medicaid utilization review and quality organization, is looking for dynamic healthcare professionals who will develop, coordinate and deliver educational activities to Medicaid providers. Position will be responsible for creating the training, designing documents, developing course design templates, being the lead scriptwriter and creating pre- and post-evaluations and assessments. Successful candidate(s) will have a BS or BA in a health related field, a Master’s is preferred. Candidate will have a background in provider relations and in creating and presenting educational training courses using web-based or other interactive technology. Advanced knowledge of Microsoft Office products required. Experience with Medicaid providers and bi-lingual Spanish/English is preferred. Some in-state travel is required.

Associate Medical Director

eQHealth Solutions, a Medicaid utilization review and quality organization is looking for an Associate Medical Director for its Florida Division. This position functions at the Physician Executive level, in conjunction with the Medical Director, responsible for clinical activities of eQHealth Solutions – Florida Division. Provides clinical leadership to the strategic, operational and quality issues of the corporation.  Ensures that all functions of the medical affairs department are carried out in a manner that meets the needs of eQHealth Solutions and its clients. Provides guidance and expertise on the utilization of  Therapy, Inpatient, Home Health, PDN and PPEC Services to first level nursing professionals.

The successful candidate must be a graduate of an approved School of Medicine or School of Osteopathy with an unrestricted license to practice medicine in the State of Florida. Board certified in Pediatrics, Family Practice or Internal Medicine.

Requirements for the position are a minimum five years clinical experience post residency. Experience in Utilization Management and Quality Improvement. Experience working with Medicaid population. Must have never been sanctioned in conjunction with activities of CMS, and never had a disciplinary action by a provider or any professional licensing board.

In addition the following background would be required; a strong working knowledge, credibility and experience working directly with outside entities such as providers, physicians,  hospital association, medical societies, home health agencies, etc. Familiarity with and commitment to, continuous quality improvement. Experience in analysis of evidence-based medicine and clinical outcomes data.  Bilingual in English/Spanish preferred. Position is located near the Tampa Airport. Candidates should submit resume/CV.

Review Therapists

eQHealth Solutions, a leader in utilization management and quality review, is hiring experienced therapists, knowledgeable in effective clinical management  to participate in the Florida Medicaid utilization review process.  We are offering an excellent employment opportunity for dynamic and motivated health care clinicians to join a team of dedicated professionals.  Successful candidates will render first level review decisions for the medical necessity of outpatient therapy services for Medicaid children under age 21.  Successful candidates will be physical therapists, occupational therapists or speech and language pathologists credentialed and licensed in the State of Florida and who have at least two (2) years therapy experience.  Prefer candidates who have experience with utilization management and who are bilingual English/Spanish.  Excellent benefit package. Send resume with salary requirements.

Statistical Analyst

Must have a degree in Statistics or related field plus 3-5 years relevant work experience in statistical analysis. Experience working with large database using SAS and/or relational database programs required along with experience with PC spreadsheet applications.  Excellent verbal and written communication skills are required as is strong analytical thinking and ability to multi-task. 

Familiarity with Medicare and/or Medicaid claims data and Medicaid utilization process required.  Experience in SQL Server 2008 Analysis Services and multidimensional OLAP cubes, Reporting Services, Integration Services and Enterprise scale complex data mining preferred. Some statistical modeling experience is also preferred.

A Statistical Analyst will perform analysis of claims and clinical databases to identify certain opportunities for improvement of health care indicators. Other essential functions include:

• Prepare and conduct analysis to support several teams. This includes helping teams solve problems.
• Solve business problems utilizing SAS along with the database information available.
• Build real-time dashboards for key performance indicators utilizing SQL Server/SAS tools.
• Effectively communicate results of analysis.

Home Health/PPEC/PDN Reviewer(s)

Employment opportunity for dynamic and motivated Health Care professional(s) who will perform pre-authorization medical record review, including the application of medical necessity criteria and identification of potential quality of care concerns relative to Home Health, Prescribed Pediatric Extended Care (PPEC) and/or Private Duty Nursing (PDN) and renders accurate review determinations. In addition, will perform care coordination and transition services as needed and appropriate. Successful candidate(s) must have at least two years of home health and two years of Pediatric experience as well as background in Medicaid and knowledge of InterQual® or Milliman®. Home health experience preferred. Strong working knowledge and experience in utilization management and/or quality assurance review required and an intermediate working knowledge of Microsoft Office products. Ability to develop effective, positive working relationships with both internal and external contacts a must. Bi-lingual Spanish/English preferred. Excellent benefit package. Please send resume with salary requirements.

Inpatient Review Nurses

Utilization Review Nurse candidates will have an active, unrestricted Florida RN license, minimum of three years in a comprehensive acute care and/or home health setting with a working knowledge of utilization and/or quality assurance review. Strong verbal and written communication skills are required. The successful candidate(s) must be completely reliable and discreet in handling confidential information, have the ability to work autonomously and must demonstrate dependability and initiative. Intermediate knowledge of Microsoft Office products required; familiarity with InterQual® or Milliman® Clinical Guidelines preferred. Bi-lingual Spanish/English a plus. Excellent benefit package. Please send resume with salary requirements.