- Evolent (Tallahassee, FL)
- …: Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, and population health opportunities using SAS, SQL, Excel, and Power ... years of analytics & reporting experience in healthcare, including medical economics, cost/ utilization analysis, and membership trend reporting. + 2+ years of SQL… more
- University of Miami (Miami, FL)
- …support system to ensure availability of accurate and timelyrevenue, cost, and utilization of data used by all levels of management within the organization.5. ... goaldirectedmanner. Works proactively to maximize the effectiveness of resource utilization . Anticipates,initiates, and facilitates problem resolution around issues of… more
- Centene Corporation (Orlando, FL)
- …issue resolution. Drive optimal performance in contract incentive performance, quality, and cost utilization . + Serve as primary contact for providers and act as a ... in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS/quality, cost and utilization , etc. + Completes special projects as assigned + Ability to travel… more
- AssistRx (Orlando, FL)
- …Responsible for forecasts and analyzing claims data to determine Copay utilization , establish escrow account minimum balances as well as replenishment needs. ... trends, patterns and behaviors as well as make recommendations to increase utilization based on Copay claims and patient compliance/adherence activities. Also, this… more
- Highmark Health (Tallahassee, FL)
- …RESPONSIBILITIES** + Monitor FDA-approvals, drug manufacturer pipelines, assess drug utilization reports, and write drug monographs for Committee review to ... Formularies by monitoring FDA-approvals and drug manufacturer pipelines, assessing drug utilization reports, and writing drug monographs for Pharmacy & Therapeutics… more
- Humana (Miramar, FL)
- …medical prescriptions and best practices in wound care but also aim at controlling utilization to improve patient outcomes. The expertise of a Home Health Wound Care ... medical prescriptions and best practices in wound care but also aim at controlling utilization to improve patient outcomes. The expertise of a Home Health Wound Care… more
- Evolent (Tallahassee, FL)
- …As a Field Medical Director, Oncology, 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
- CVS Health (Tallahassee, FL)
- …for the EAP On-Site Counseling Program, ensuring customer satisfaction and successful utilization of the EAP On-Site product, services, and solutions. + Manages ... and challenges to provide tailored support and consultation. + Helps optimize utilization of company products, including EAP On-Site services, and solutions to… more
- CenterWell (Tampa, FL)
- …managing populations and coordinating care to reduce acute and post-acute care utilization . The Manager role is hybrid with travel requirements to preferred ... and create action plans that will reduce acute and post-acute care utilization . + Solicits/shares feedback with market leaders on team-based focus with attention… more
- MyFlorida (Deland, FL)
- …with contract OJT requirements. Reviews contractor progress in attaining DBE utilization ; recommends utilization changes. Reviews DBE payment data. Provides ... annually and at contract completion overall attainment of DBE compliance utilization . Conducts and reports associated DBE compliance reviews and monitor corrective… more