- Elevance Health (Tampa, FL)
- …an equivalent background. + For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years of experience providing ... East Coast time zone hours.** The **Medical Director** will be responsible for utilization review case management for Commercial business in the New England (CT, ME,… more
- CenterWell (Tallahassee, FL)
- …short-term interventions, and connection to community-based resources. This role brings behavioral health expertise and addresses social determinants of ... of an interdisciplinary team-particularly in partnership with primary care teams, community health workers, pharmacists, and behavioral health specialists.… more
- Ascension Health (Jacksonville, FL)
- …Officer to join our team! **Benefits** Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans ... performance and quality improvement, risk management and efficient resource utilization . + Provides leadership to management within areas of responsibility,… more
- Highmark Health (Tallahassee, FL)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job works collaboratively riskacross Highmark Health clinical areas to support clinical ... Compliance Analyst is responsible for monitoring and analyzing medical and utilization management activities to ensure compliance with internal policies, state, CMS,… more
- Highmark Health (Tallahassee, FL)
- …**JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most ... URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member of the multidisciplinary team… more
- Veterans Affairs, Veterans Health Administration (Gainesville, FL)
- …to veteran patients according to the North Florida/South Georgia VA Health System mission and the Physical Medicine and Rehabilitation guidelines. Employees ... therapy interventions for treating patients with complex medical or mental health issues, such as polytrauma, traumatic brain injury (TBI), posttraumatic stress… more
- Highmark Health (Tallahassee, FL)
- …agreements. Monitor financial performance of contracts by tracking utilization and competitive environment, including group specific performance guarantees. ... designs, competitive position, product development, network options, strategic partnerships, utilization review, local/national client demographics and dentist distribution. Interpret… more
- HCA Healthcare (Tallahassee, FL)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed ... Services in Leon and Gadsden Counties. Our facilities include a state-of-the-art Behavioral Health Center, Cancer Center, Chest Pain Center w/PCI-Resuscitation,… more
- HCA Healthcare (Gainesville, FL)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed ... Hospital, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...quality and cost improvement and develops systems to review utilization of resources and objectively measure outcomes of care… more
- MyFlorida (Tallahassee, FL)
- MEDICAL/ HEALTH CARE PROG ANALYST - SES - 64053708 Date: Aug 5, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... Website (http://www.dms.myflorida.com/workforce\_operations/human\_resource\_management/for\_job\_applicants/e\_verify) . Requisition No: 854383 Agency: Department of Health Working Title: MEDICAL/ HEALTH CARE PROG ANALYST… more