- Molina Healthcare (FL)
- …professionals in some or all of the following functions: care management, utilization management, behavioral health , care transitions, long-term services ... Assists in implementing health management, care management, utilization management, behavioral health and...state of practice. * Certified Case Manager (CCM), Certified Professional in Health Care Management certification (CPHM),… more
- HCA Healthcare (Tallahassee, FL)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed ... rewarding it can be to reach your personal and professional goals. Help to advance the practice of nursing...Leon and Gadsden Counties. Our facilities include a state-of-the-art Behavioral Health Center, Cancer Center, Chest Pain… more
- HCA Healthcare (Fort Walton Beach, FL)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed ... to be a part of our team. **Job Summary and Qualifications** The Mental Health Professional III role will deliver exceptional psychiatric treatment to patients… more
- HCA Healthcare (Tallahassee, FL)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed ... Services in Leon and Gadsden Counties. Our facilities include a state-of-the-art Behavioral Health Center, Cancer Center, Chest Pain Center w/PCI-Resuscitation,… more
- HCA Healthcare (Tallahassee, FL)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed ... Services in Leon and Gadsden Counties. Our facilities include a state-of-the-art Behavioral Health Center, Cancer Center, Chest Pain Center w/PCI-Resuscitation,… more
- Highmark Health (Tallahassee, FL)
- …SUMMARY** This job requires the ability to identify issues related to professional and facility provider claims data including determining appropriateness of code ... data to assure appropriate level of payment and resource utilization . It is also used to identify issues which...measurable outcomes. Will monitor and analyze the delivery of health care services in accordance with claims submitted, and… more
- Elevance Health (FL)
- …law. The **Medical Director** is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... state or territory of the United States when conducting utilization review or an appeals consideration and cannot be..._For Health Solutions and Carelon organizations (including behavioral health ) only, a minimum of 5… more
- HCA Healthcare (Bradenton, FL)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed ... Hospital, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...quality and cost improvement and develops systems to review utilization of resources and objectively measure outcomes of care… more
- Highmark Health (Tallahassee, FL)
- …agreements. Monitor financial performance of contracts by tracking utilization and competitive environment, including group specific performance guarantees. ... designs, competitive position, product development, network options, strategic partnerships, utilization review, local/national client demographics and dentist distribution. Interpret… more
- Elevance Health (Tampa, FL)
- …an equivalent background. + For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years of experience providing ... is responsible for the review of appeals for physical health medical services, to ensure the appropriate and most...state or territory of the United States when conducting utilization review or an appeals consideration and cannot be… more