- Molina Healthcare (Tampa, FL)
- …dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to ... -related regional medical necessity reviews and cross coverage. * Standardizes behavioral health -related utilization management, quality, and financial… more
- Devereux Advanced Behavioral Health (Viera, FL)
- **Description** Are you looking to advance your career in Admissions & Utilization Review ? If you answered yes, then consider joining our team where you can take ... your career to the next level. **Being the Utilization Review Coordinator at Devereux has its...Devereux has its Advantages!** Devereux Florida is a nonprofit behavioral health organization that provides a wide… more
- Centene Corporation (Tallahassee, FL)
- …degree for behavioral health clinicians required. Behavioral health clinical knowledge and ability to review and/or assess ABA Treatment Plans ... of care and services are medically appropriate related to behavioral health (BH) and/or autism spectrum disorder...required. Knowledge of ABA services and BH utilization review process required. Experience working with… more
- Elevance Health (Tampa, FL)
- …is responsible for managing a team of physical and/or behavioral health practitioners responsible for coordinating member service, utilization , access, care ... management and/or concurrent review to ensure cost effective utilization of health , mental health , and substance abuse services for one or more member… more
- Elevance Health (Tampa, FL)
- ** Behavioral Health Medical** **Director-Psychiatrist** **Appeals** **Location:** This role enables associates to work virtually full-time, with the exception of ... The **Medical Director** is responsible for the administration of behavioral health medical services, to ensure the...state or territory of the United States when conducting utilization review or an appeals consideration and… more
- CenterWell (Tallahassee, FL)
- …best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can ... part of our caring community and help us put health first** Conviva Care Solutions is seeking a RN...medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part… more
- Molina Healthcare (Miami, FL)
- **JOB DESCRIPTION** **Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management ... and chemical dependency services and assists with implementing integrated Behavioral Health care management programs. **Knowledge/Skills/Abilities** Provides… more
- Elevance Health (FL)
- **JR169828 Behavioral Health Care Manager II** Responsible for managing psychiatric and substance abuse or substance abuse disorder facility-based and outpatient ... professional treatment health benefits through telephonic or written review ....Requires MA/MS in social work counseling or a related behavioral health field or a degree in… more
- CVS Health (Tallahassee, FL)
- …other clinical services that are evidence-based. * Work collaboratively with the Behavioral Health , Pharmacy, Member Outreach, Care Management, National Quality ... to improve health outcomes. * Leverage extensive knowledge of health care delivery system, utilization management, reimbursement methods and treatment… more
- Highmark Health (Tallahassee, FL)
- …SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health care services, application of ... utilization , identification of opportunities for referral to a Health Coach/case management, and identification and resolution of quality issues. Monitors… more