- The Cigna Group (Tallahassee, FL)
- …to manage new and existing workflows. Monitors overall operations including review of internal reports and ad-hoc data analysis associated with operational ... enhance operational performance. **RESPONSIBILITIES** * Gains an understanding for utilization management, claims operations, IT operations, and call center… more
- Sharecare (Tallahassee, FL)
- …techniques, the nurse helps to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also ... in the orientation and to take the pre and post tests to review competency during orientation. Yearly competency tests are required for all Sharecare clinicians.… more
- Anywhere Real Estate (Miami, FL)
- …problems; + Work with the Engineering team to conduct design and peer code review ; + Acquire knowledge of existing systems and the underlying business processes they ... customers, analysts, data scientists, and operations teams which will increase the utilization of our products and achieve competitive advantage; + Remain abreast of… more
- Molina Healthcare (St. Petersburg, FL)
- …requestors to ensure appropriate creation of reports and analyses. Uses peer-to-peer review process and end-user consultation to reduce errors and rework + Practice ... + Demonstrate Healthcare experience in Quantifying, Measuring and Analyzing Financial and Utilization Metrics of Healthcare + Advanced knowledge of SQL + Proficient… more
- Centene Corporation (Tallahassee, FL)
- …management, cost containment, and medical quality improvement activities. + Performs medical review activities pertaining to utilization review , quality ... with respect to clinical issues and policies. + Identifies utilization review studies and evaluates adverse trends...plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay… more
- Amentum (Kennedy Space Center, FL)
- …Asset Management principles and continuous improvements through best practices and utilization of Maximo, provide data base administration, software enhancements and ... testing, training, and implementation of major software upgrades. + COMET Facility Utilization Management (DFUM) group that assess space utilization requests,… more
- Humana (Tallahassee, FL)
- …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all… more
- Kemper (Jacksonville, FL)
- Location(s) Remote -AL, Remote -CT, Remote -FL, Remote -GA, Remote -IL, Remote -IN, Remote -MI, Remote -NC, Remote -OH, Remote -PA, ... complex technical problems and issues with assigned applications and work processes. + Review and recommend test plans for impacted areas and end to end test… more
- CenterWell (Tallahassee, FL)
- …member service or customer service telephone experience desired + Experience with Utilization Review and/or Prior Authorization, preferably within a managed care ... a part of our caring community and help us put health first** Utilization Management Administration Coordinator II , non-clinical, supports the UM operations by… more
- CVS Health (Tallahassee, FL)
- …And we do it all with heart, each and every day. **Position Summary** Fully remote , Monday-Friday 8am - 5pm EST position (shifts may vary based on business needs) ... level. The Associate Manager is also responsible for oversight of utilization management nurses including the organization and development of high performing… more