- 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
- CVS Health (Tallahassee, FL)
- …- Emergency/critical care experience - Experience working Grievance cases - Case Management or Utilization Management experience - Managed care ... all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit… more
- Elevance Health (Tampa, FL)
- …current active unrestricted RN license is strongly preferred. + 5+ years of utilization management experience strongly desired. + Exposure to Overpayment Claim ... **Manager I Medical Management (Prior Authorizations) - Florida Medicare** **Office Locations:**...granted as required by law._ The **Manager I Medical Management (Prior Authorizations)** is responsible for managing a team… more
- Evolent (Tallahassee, FL)
- …As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... the Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- Evolent (Tallahassee, FL)
- …Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... the Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- Evolent (Tallahassee, FL)
- …specialty match reviewer for Spine Surgery cases. you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... the Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- CVS Health (Tallahassee, FL)
- …on outreach priorities based on service territory and capacity constraints + System Utilization & Workflow Management + Operate and maintain Salesforce Field ... day. We are seeking a proactive and highly organized Manager of Production Management to join the Signify Health team to oversee field service dispatch operations… more
- HCA Healthcare (Tallahassee, FL)
- …and assess observation patients for appropriateness in observation status + Performs utilization management reviews and communicates information to third party ... is acceptable for position if current and compliant** + **Certification in Case Management , Nursing, or Utilization Review, preferred** + **Three years of… more
- HCA Healthcare (Tallahassee, FL)
- …and assess observation patients for appropriateness in observation status + Performs utilization management reviews and communicates information to third party ... is acceptable for position if current and compliant** + **Certification in Case Management , Nursing, or Utilization Review, preferred** + **Three years of… more
- Community Based Care of Brevard, Inc. (Sanford, FL)
- …and a web-based application for daily entry of case activity and the utilization management of service authorizations. 2+ years of Team Facilitation Skills ... Position Summary: This position oversees and manages the authorization and utilization of services delivered for families determined by the Department of… more