- Molina Healthcare (Tampa, FL)
- …healthcare services professionals, in some or all of the following functions: utilization management , care management , care transitions, behavioral health, ... or more of the following key health care services (HCS) functions: care management , care transitions, utilization management , behavioral health and/or nurse… more
- Select Medical (Miami, FL)
- … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning, treatment plan management and financial… more
- Select Medical (Lake Worth, FL)
- … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning, treatment plan management and financial… more
- Community Based Care of Brevard, Inc. (Brevard, FL)
- …Position Summary: This position is responsible for the clinical coordination, utilization management , and authorization of initial and ongoing services ... ensuring the most efficient and effective use of agency resources. Utilization Management - Essential Function: Ensure that services authorized are clinically… more
- Molina Healthcare (Tampa, FL)
- …retrieving specified information from data sources. + Knowledge of healthcare operations ( utilization management , disease management , HEDIS quality measures, ... and Finance team through analyzing key business issues related to cost, utilization and revenue for multiple Molina Healthcare products. Analyzes data and dashboard… more
- Elevance Health (Panama City, FL)
- …associates, and may be involved in process improvement initiatives. + Submits utilization /authorization requests to utilization management with documentation ... integrated care plan, engaging the member's circle of support and overall management of the individuals physical health (PH)/behavioral health (BH)/LTSS needs, as… more
- Evolent (Tallahassee, FL)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... **What You Will Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company policies and… more
- HCA Healthcare (Sanford, FL)
- …with physicians, patients, families, hospital staff, and outside agencies + Performs utilization management reviews and communicates information to third party ... is preferred + BSN is preferred + Certification in Case Management , Nursing or Utilization Review is preferred HCA Florida Lake Monroe Hospital is a 221-bed… more
- HCA Healthcare (Sun City Center, FL)
- …of experience in a healthcare environment + Previous experience in accreditation, quality, utilization management , or risk management required. + Knowledge ... **Job Summary and Qualifications** We are seeking a Director of Quality Management . As our Director, you willprovide direction to ensure the facilitation and… more
- Ascension Health (Jacksonville, FL)
- …of recent work experience in a hospital setting, preferably with some Physician Advisory/ Utilization Management work experience. If you are ready to join a ... **Details** + **Specialty** : Case Management + **Subspecialty:** Physician Advisor + **Schedule** : Full Time | Hybrid (frequently on site) + **Call Schedule:** No… more