- Humana (Tallahassee, FL)
- …caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral health ... services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work assignments are varied and… more
- Centene Corporation (Tallahassee, FL)
- …in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of ... outlined by the applicable state required. Master's degree for behavioral health clinicians required. Clinical knowledge and...and Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN… more
- Humana (Tallahassee, FL)
- …Qualifications** + Expertise on NCQA accreditation standards, especially related to Utilization Management and/or Behavioral Health ; MED-Deeming ... degree. + Minimum 3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management +...standards knowledge is a plus. + Registered Nurse or Behavioral Health Licensed Professional . +… more
- Molina Healthcare (Tampa, FL)
- …Association** Active, unrestricted Utilization Management Certification (CPHM), Certified Professional in Health Care Quality (CPHQ), or other healthcare ... plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential.… more
- Centene Corporation (Tallahassee, FL)
- …experience in applied behavioral analytics (ABA). Additional Details: * Department: Behavioral Health Utilization Management * Business Unit: Corporate / ... of care and services are medically appropriate related to behavioral health (BH) and/or autism spectrum disorder...and Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN… more
- Monte Nido (Miami, FL)
- …across programs. + Leverage understanding of medical necessity criteria and current behavioral health insurance landscape in verbal and written communications ... care. + Experience providing direct care to individuals with an eating disorder preferred. + Licensed behavioral health clinician/provider, RD, or RN \#montenido more
- Humana (Tampa, FL)
- …caring community and help us put health first** The Field Care Manager, Behavioral Health 2 assesses and evaluates member's needs and requirements to achieve ... appropriate for the care and wellbeing of members. The Field Care Manager, Behavioral Health 2 work assignments are varied and frequently require interpretation… more
- Centene Corporation (Tallahassee, FL)
- …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/ Health Services team. Centene is a diversified, ... in order to facilitate implementation of recommendations to providers that would improve utilization and health care quality. + Reviews claims involving complex,… more
- HCA Healthcare (Gainesville, FL)
- …by case basis** **Introduction** Do you have the career opportunities as a(an) Mental Health Professional III Licensed you want with your current employer? We ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free...colleagues. Do you want to work as a(an) Mental Health Professional III Licensed where your passion… more
- HCA Healthcare (Gainesville, FL)
- …intrinsic worth of each individual is recognized. Submit your application for our Mental Health Professional III Lic PRN opening with HCA Florida North Florida ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free...may vary by location._** We are seeking a(an) Mental Health Professional III Lic PRN for our… more