- Humana (Tallahassee, FL)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- Humana (Tallahassee, FL)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement...with prior experience participating in teams focusing on quality management , utilization management , case … more
- Humana (Tallahassee, FL)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- Molina Healthcare (Orlando, FL)
- …experience as a Molina Medical Director + Demonstrated experience in Utilization /Quality Program management + Previous leadership experience + Peer review, ... of prior authorization, inpatient concurrent review, discharge planning, case management and interdisciplinary care team activities. + Ensures that authorization… more
- Actalent (Sunrise, FL)
- Actalent is hiring a Utilization Management Nurse! Job Description The Utilization Management Nurse (UMN) collaborates closely with the interdisciplinary ... present reports on department activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management + InterQual + Milliman… more
- CVS Health (Tallahassee, FL)
- …every day. **Position Summary** **Fully remote with requirement to reside in Florida.** + Utilization Management is a 24/7 operation and the work schedule may ... specific criteria to authorize procedures/services or initiate a Medical Director referral as needed. **Required Qualifications** + Must have...in Florida + 3+ years of clinical experience + Utilization Management is a 24/7 operation and… more
- Monte Nido (Miami, FL)
- …while providing the opportunity for people to realize their healthy selves. ** Utilization Review Clinician** **Monte Nido** **Remote - EST or CST hours** **Monte ... to provide comprehensive care within an intimate home setting. The Utilization Review **Clinician** is responsible for conducting daily administrative and… more
- Select Medical (Gainesville, FL)
- …focus on resource management . + Demonstrating compliance with facility-wide Utilization Management policies and procedures. + Coordinating UR compliance with ... **Overview** **Critical Illness Recovery Hospital** ** Director of Case Management ** **$10,000 Sign...growth of the department, including, but not limited to: Utilization Review (UR) and resource management , discharge… more
- HCA Healthcare (Kissimmee, FL)
- …charitable organizations. Apply Today! **Job Summary and Qualifications** The Facility Case Management Director has the overall responsibility for managing and ... We care like family! Jump-start your career as a Director Case Management today with HCA Florida...to ensure continuity of care and optimal clinical resource utilization . The Director has oversight for all… more
- AdventHealth (Altamonte Springs, FL)
- …FL **The role you will contribute:** The Physician Advisor provides primary support for Utilization Management (UM) and secondary support for Care Management ... Physician Advisor is responsible for educating, informing and advising members of the Utilization Management , Care Management , Managed Care and Revenue Cycle… more