- Veterans Affairs, Veterans Health Administration (Bay Pines, FL)
- …lifecycle (which includes planning, requirement determination, procurement, maintenance/upgrade, management / utilization and disposal). Develops a formalized ... Supply Chain Officer (CSCO) is the senior supply chain management officer for a VA Health Care System (VA...Major Duties Include: Integrates and aligns acquisition, delivery and management of supplies, equipment and services to ensure the… more
- AdventHealth (Orange City, FL)
- …of Nursing. + Health-related Master's degree or MSN. + Prior Care Management / Utilization Management experience. + ACM/CCM Certification. This facility ... Manager is under the general supervision of the Care Management Supervisor or Manager or Director of Nursing and...physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge… more
- Highmark Health (Tallahassee, FL)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member...member of the multidisciplinary team for case and disease management . They will advise the multidisciplinary team on cases,… more
- BayCare Health System (St. Petersburg, FL)
- …Care Clinic Supervisor** is a full-time position. **Responsibilities** + Oversee the utilization management and daily business operations of their assigned ... + Oversees maintenance and purchasing for specific clinics. + Responsible for utilization management , clinical support management , quality improvement,… more
- Bluestone Physician Services (Orlando, FL)
- …with primary care teams to ensure high quality team-based care + Use utilization management tools to facilitate appropriate transitional care management ... their unique needs. Using an evidence-based approach focused on quality care management and data-driven medical decisions, Bluestone care teams collaborate to manage… more
- AdventHealth (Deland, FL)
- …+ BSN + Health-related Master's degree or MSN + Prior Care Management / Utilization Management experience ACM/CCM Certification This facility is ... patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the interdisciplinary team… more
- Prime Therapeutics (Tallahassee, FL)
- …and works collaboratively with key internal stakeholders including Clinical, Clinical Program Management , and Utilization Management to deliver financial ... cliff opportunities + Serve as interdepartmental bridge between Trade, Clinical Program Management , Clinical, Utilization Management and other stakeholders… more
- Molina Healthcare (FL)
- …Masters Degree in Behavior Analysis or a related field. **Preferred Experience** Utilization Management experience Health Plan/MCO work experience To all current ... of stay for requested treatments and/or procedures. * Works collaboratively with the Utilization and Case Management departments to provide ABA/BHT services to… more
- Humana (Tallahassee, FL)
- …working with CMS Guidelines, MCG and/or InterQual guidelines. + 2+ years of Utilization Management (UM), Pre-Auth, and/or other managed care review experience. + ... internal stakeholders for review depending on case findings. Educates providers on utilization and medical management processes. + Enters and maintains pertinent… more
- Elevance Health (Tampa, FL)
- …preferred. + Extensive spine surgery experience preferred. + Experience with utilization management , especially with CMS guidelines preferred. + **Orthopedic ... Associate Medical Director** **Orthopedic Spine Surgery** **Carelon Medical Benefit Management ** **Schedule: 10:30 AM-7 PM Central** **Virtual:** This role enables… more