- BayCare Health System (Clearwater, FL)
- …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Management Assistant responsibilities include:** + Participating on the ... Utilization Management Team (UMT), serving as a Utilization Management liaison with managed care organizations, collaborating with Medical Staff, Business Office,… more
- Elevance Health (Tampa, FL)
- …by law. *Must reside in the state of Florida* The **Manager of Utilization Management** is responsible for managing a team of physical and/or behavioral health ... practitioners responsible for coordinating member service, utilization , access, care management and/or concurrent review to ensure cost effective utilization of… more
- Centene Corporation (Tallahassee, FL)
- …and criteria + Analyzes BH member data to improve quality and appropriate utilization of services + Interacts with BH healthcare providers as appropriate to discuss ... + Provides education to members and their families regrading ABA and BH utilization process + Provides feedback to leadership on opportunities to improve care… more
- CVS Health (Tallahassee, FL)
- …external constituents in the coordination and administration of the utilization /benefit management function.* Meet set productivity and quality expectations ... of clinical experience in acute or post-acute setting,and 1+ years of Utilization Management / CareManagementExperience + Must have active current and unrestricted… more
- CVS Health (Tallahassee, FL)
- …of clinical experience in acute or post-acute setting, and 1+ years of Utilization Management / Care Management Experience + Must have active current and ... additional Nursing Licenses as business needs require. **Preferred Qualifications** Utilization Management experience preferred **Education** Education: Diploma RN acceptable;… more
- CenterWell (Tallahassee, FL)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare +… more
- Wolters Kluwer (Tampa, FL)
- …Engagement Manager plays a high-impact role in managing strategy and product utilization across the Wolters Kluwer Health's Clinical Decision Support & Provider ... are established and strengthened, drive product adoption and ensure utilization goals are achieved to maximize value realization, implementation projects… more
- Highmark Health (Tallahassee, FL)
- …This role supports the full application product lifecycle for **clinical and utilization management software** , with a specific focus on driving key technical ... They function as a pivotal bridge, translating high-level **clinical and utilization management software** business needs into detailed technical requirements for… more
- 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 to ensure ... most appropriate care at the most effective setting. *Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and under-… more
- Centene Corporation (Tallahassee, FL)
- …in Florida + Board certified in Pediatrics or Family Medicine + Utilization Management experience and knowledge of quality accreditation standards. + Actively ... for the business unit. + Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. + Performs… more