- CVS Health (Tallahassee, FL)
- …years of regulatory and/or clinical audit experience. + Experience in medical management , including Utilization Management ( UM ) and Case Management ... accreditation processes, and NCQA standards. + Licensed clinical professional ( RN preferred). + Excellent analytical, organizational, and communication skills. +… more
- University of Miami (Coral Gables, FL)
- …potential problem situations, intervenes, removes and reports defective equipment to management , Bio- Medical and Equipment Company. + Monitors preventive ... procedures such as: nerve blocks, spinals, emergency intubation + Use available RN resources when questions arise. + Takes action in emergency/rapidly changing… more
- Elevance Health (Tampa, FL)
- …The Behavioral Health Care Manager I is responsible for conducting utilization management reviews for mental health and substance use disorder inpatient and ... necessary quality behavioral healthcare in a cost-effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to Peer Reviewers as… more