- Molina Healthcare (Jacksonville, FL)
- …of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies ... the most appropriate care at the most effective setting. *Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and… more
- Zelis (FL)
- …. + 5+ years in leadership role . + Demonstrated success in revenue management and increased utilization within an assigned book of business for individually ... interests that shape who you are. Position Overview The Director , Client Solutions will lead a team focused on...for all clients within their book of business . Management of revenue for assigned clients inclusive of: .… more
- Molina Healthcare (Orlando, FL)
- …health oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs ... - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and… more
- Select Medical (Miami, FL)
- …with Select Medical* **Location: Miami, FL** **$20,000 Sign-on Bonus** ** Director of Quality Management ** **(DQM)** **Responsibilities** **Position Summary** ... Orthopedic Conditions + Multiple Traumas Apply for this job (https://jobs-selectmedicalcorp.icims.com/jobs/333333/ director -of-quality- management inpatient-rehab/job?mode=apply&apply=yes&in\_iframe=1&hashed=1374627814) Share this job **Job ID**… more
- Select Medical (Miami, FL)
- …, while also completing medical record documentation. You will report directly to the Director of Case Management and provide social work services, as ... right. The Case Manager is responsible for utilization reviews and resource management , discharge planning,...the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates… more
- Select Medical (Pensacola, FL)
- …, while also completing medical record documentation. You will report directly to the Director of Case Management and provide social work services, as ... right. The Case Manager is responsible for utilization reviews and resource management , discharge planning,...the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates… more
- Elevance Health (Miami, FL)
- …Capabilities and Experiences:** + Child and Adolescent experience preferred. + Utilization Management experience. + Applied Behavior Analysis (ABA) experience. ... **Behavioral Health Medical** ** Director -Psychiatrist** **Appeals** **Location:** This role enables associates to...aspects of a program. + Conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers… more
- Select Medical (Oxford, FL)
- …, while also completing medical record documentation. You will report directly to the Director of Case Management and provide social work services, as ... right. The Case Manager is responsible for utilization reviews and resource management , discharge planning,...the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates… more
- CenterWell (Jacksonville, FL)
- …of our caring community and help us put health first** The Associate Medical Director (AMD) is an instrumental clinical leader of our primary care team, combining ... clinical practice with leadership and operational management to ensure high-quality patient care and alignment with Value-Based Care (VBC) principles. This… more
- CenterWell (Daytona Beach, FL)
- …and help us put health first** Job Description Summary The Associate Medical Director (AMD) is an instrumental clinical leader of our primary care team, combining ... clinical practice with leadership and operational management to ensure high-quality patient care and alignment with Value-Based Care (VBC) principles. This… more