- CVS Health (Tallahassee, FL)
- …members. **Position Summary** The Associate Manager is responsible for oversight of Utilization Management staff. This position is responsible for the ... team maintains compliance and privacy practices. + Oversees the implementation of utilization management services for assigned area + Implements clinical… more
- Humana (Tallahassee, FL)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to support ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and… more
- Humana (Tallahassee, FL)
- …a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and… more
- AdventHealth (Tampa, FL)
- …diseases. **The ro** **le you'll contribute:** The role of the Emergency Department Utilization Management (UM) Registered Nurse (RN) is to use clinical ... leader for additional review as determined by department standards. The Utilization Management Nurse is accountable for a designated patient caseload and… more
- 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,… more
- BayCare Health System (Tampa, 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,… more
- CVS Health (Tallahassee, FL)
- …Evaluates, designs, and implements new regulatory and/or business initiatives for Utilization Management from initiation through completion. + Partners ... within clinical and health plan operations and value creation methodologies including Utilization and Policy Management , Care Management and Coordination,… more
- Community Based Care of Brevard, Inc. (Orlando, FL)
- …a web-based application for daily entry of case activity and the utilization management of service authorizations. Educational and Experience Requirements: MA/MS ... Position Summary: The UM Program Manager provides oversight and management of service authorization data validation, reporting and trend...summ ar ize d ata wit h in the Utilization M an agementSys tem to pr eparere por… more
- Elevance Health (Miami, FL)
- ** Utilization Management Representative I** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person ... 10 AM to 6:30 PM Eastern. Training hours may vary. The ** Utilization Management Representative I** is responsible for coordinating cases for precertification and… more
- Cognizant (Tallahassee, FL)
- …. Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' ... in health care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and Grievances, precertification, initial… more