- ChenMed (Lauderhill, FL)
- …leaders, external clients and HMO to establish, maintain and support outpatient utilization management in PMR and delegated utilization management in ChenMed ... **_Other responsibilities may include:_** + Drive the current delegated/non-delegated utilization management model to a sustainable and reproducible one dependent… more
- Evolent (Tallahassee, FL)
- …the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to make a ... meaningful impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your… more
- RxBenefits (Jacksonville, FL)
- …channel management, B/G classifications, specialty designations, rebate eligibility, utilization trend, Utilization Management (UM) implications, Manufacturer ... structure, new prospect member size, marketing agreements, broker commissions, and drug utilization . + Be the SME on dozens of medical vendor/PBM contracts including… more
- Community Based Care of Brevard, Inc. (Rockledge, FL)
- …an individualized case plan outlining family needs, goals and services. Service Utilization UM/Wrap: This is strongly recommended in order to manage and track ... the daily service utilization log, monitors costs and tracks 3rd party resources....resources and adhere to policies and procedures. Responsible for utilization and monitoring flexible funding and service coordination in… more
- Evolent (Tallahassee, FL)
- …As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in ... to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization … more
- HCA Healthcare (Bradenton, FL)
- …environment of quality and cost improvement and develops systems to review utilization of resources and objectively measure outcomes of care in the inpatient ... medical staff regarding clinical resource management, appropriate documents standards, utilization and quality issues, and quality improvement activities, in… more
- Molina Healthcare (Miami, FL)
- …Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental health and chemical ... Health care management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization management and case management programs for mental health… more
- Evolent (Tallahassee, FL)
- …As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in ... to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization … more
- Community Based Care of Brevard, Inc. (Rockledge, FL)
- …Position Summary: This position oversees and manages the authorization and utilization of services delivered for families determined by the Department of ... to maximize resources and adhere to policies and procedures. Responsible for utilization and monitoring flexible funding and service coordination in order to meet… more
- HCA Healthcare (Kissimmee, FL)
- …hospitalists and PCPs to address and resolve issues related to facility utilization and patient flow process and facilitate strong working relationship between ... caregivers, case management, and admitting departments to promote effective utilization management through coordination of efforts involving patient flow. **GENERAL… more