- Centene Corporation (Tallahassee, FL)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... a fresh perspective on workplace flexibility. **Position Purpose:** Performs a clinical review and assesses care related to mental health and substance abuse.… more
- Centene Corporation (Tallahassee, FL)
- …assess ABA Treatment Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with providers and healthcare ... behavioral analytics (ABA). Additional Details: * Department: Behavioral Health Utilization Management * Business Unit: Corporate / Florida *...teams to review care services related to Applied Behavior Analysis Services… more
- Monte Nido (Miami, FL)
- …lives while providing the opportunity for people to realize their healthy selves. ** Utilization Review Clinician** **Monte Nido** **Remote - EST or CST hours** ... provide comprehensive care within an intimate home setting. The Utilization Review **Clinician** is responsible for conducting...LPC, LMHC, or Bachelor's Degree in nursing preferred. + Licensed and currently registered in the state you are… more
- Trinity Health (Fort Lauderdale, FL)
- …Care Plans to ensure authorization for hospital stay. Hybrid Position **_Position Purpose:_** ** Utilization Review (UR) Nurses play a vital role in healthcare by ... hospital clinical experience is required.** Recent experience in case management, utilization review , discharge planning, ongoing monitoring and evaluation of… more
- CVS Health (Tallahassee, FL)
- …UM ( utilization management) experience within an **outpatient** setting, concurrent review or prior authorization. + 5 years of a variety clinical experience ... with multi-state/compact privileges and have the ability to be licensed in all noncompact states. + Required to use...call center environment. + 1 year of varied UM ( utilization management) experience within an inpatient, concurrent review… more
- Molina Healthcare (FL)
- …stay for requested treatments and/or procedures. * Works collaboratively with the Utilization and Case Management departments to provide ABA/BHT services to Molina ... 3+ years working as Behavior Analyst **Required License, Certification, Association** ** Licensed , or Board Certified, as a Behavior Analyst** **Preferred Education**… more
- HCA Healthcare (Gainesville, FL)
- …guidelines. Participates in developing department goals and clinical programming. + Performs utilization review as assigned. + Helps with Process and Quality ... you to apply for our Mental Health Professional III Licensed opening. We promptly review all applications. Highly qualified candidates will be contacted for… more
- MyFlorida (Land O' Lakes, FL)
- SENIOR LICENSED PRACTICAL NURSE - 50000083 1 Date: Aug 4, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 857808 Agency: Veterans Affairs Working Title: SENIOR LICENSED PRACTICAL NURSE - 50000083 1 Pay Plan: Career Service Position… more
- CVS Health (Tallahassee, FL)
- …inpatient, skilled nursing, or rehabilitative stay. Under the direction of a Registered/ Licensed RN, the TOC Coach ensures the member experiences a seamless ... who cannot advocate for themselves. The TOC team will review prior claims to address potential impact on current...community + Utilizes weekly and daily reporting to identify utilization for the purpose of reducing Emergency Department … more
- AdventHealth (Daytona Beach, FL)
- **Health Coach Licensed Practical Nurse** **AdventHealth** **Ventures** **All the benefits and perks you need for you and your family:** + Up to $2000 Sign On Bonus ... goals to enhance quality, patient satisfaction, and reduce unnecessary healthcare resource utilization , thereby creating a new paradigm in how whole-person care is… more