- Centene Corporation (Tallahassee, FL)
- …must be a Florida resident. + Provides medical leadership of all for utilization management , cost containment, and medical quality improvement activities. + ... Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate,… more
- Elevance Health (Tampa, FL)
- …in multiple states. **Preferred Skills, Capabilities and Experience:** + Experience in Utilization Management and/or Long Term Care Services Strongly Preferred. ... for people enrolled in Medicaid and/or Medicare programs in Florida. **Medical Management Clinician Associate** **Location:** The candidate must reside in the state… more
- AdventHealth (Orlando, FL)
- …and serves as a resource to Medical Staff colleagues regarding best practices, Utilization Management and Care Management structures, and functions and ... facilitates productive internal/external relationships with all physicians and constituents of Utilization Management , Care Management and CDI departments.… more
- Amentum (Kennedy Space Center, FL)
- …and testing, training, and implementation of major software upgrades. + COMET Facility Utilization Management (DFUM) group that assess space utilization ... utilization of space across the contract. + Assist management in resource estimates that comply with budget limitations...internal and external customers. + Ensure and enable the utilization of GSS Work Management to assign,… more
- Evolent (Tallahassee, FL)
- …the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to ... meaningful impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use… more
- AdventHealth (Orlando, FL)
- …or Social Worker: BSW Masters in related field 3 years in direct Care Management / Utilization Management experience in an acute care setting **Preferred ... outpatients each year **The role you'll contribute:** **The Care Management Manager is under the general leadership of the...Manager is under the general leadership of the Care Management Facility Director and has the responsibility of the… more
- AdventHealth (Altamonte Springs, FL)
- …base development. + Clinical leadership skills encompass quality and utilization management , clinical effectiveness, outcomes programs, clinical staff ... and responsibilities, acting as a vital liaison between physicians and Case Management staff to optimize resource utilization , ultimately resulting in enhanced… more
- HCA Healthcare (Gainesville, FL)
- … review/ management . + Consults with facility-level staff regarding delegated utilization management and disease management operations under managed ... ongoing in-service programs to facility medical staff regarding clinical resource management , appropriate documents standards, utilization and quality issues,… more
- Veterans Affairs, Veterans Health Administration (Miami, FL)
- …achieve goals for eligibility, referral and authorization, care coordination, and utilization management to ensure improved Veteran experience. Makes ... improving the Veteran's experience and outcomes. Defines mental health policies, utilization management process and procedures, financial and utilization… more
- Evolent (Tallahassee, FL)
- …training classes as needed for new hires to educate and train on Utilization management system and Field Medical Director process, standards and resources. ... requested basis, reviews appeal cases and/or attends hearings for discussion of utilization management decisions. + Strong partnership with Physician Business… more