• Utilization Review Clinician - ABA

    Centene Corporation (Tallahassee, FL)
    …as experience in applied behavioral analytics (ABA). Additional Details: * Department: Behavioral Health Utilization Management * Business Unit: ... million members as a clinical professional on our Medical Management / Health Services team. Centene is a diversified,...of care and services are medically appropriate related to behavioral health (BH) and/or autism spectrum disorder… more
    Centene Corporation (08/02/25)
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  • Case Manager Registered Nurse

    CVS Health (Tallahassee, FL)
    …appropriate member care. . Attends and participates in case rounds, including utilization management rounds for behavioral health and physical health ... Mileage is reimbursed per our company expense reimbursement policy **Preferred Qualifications:** . Behavioral Health Experience . Case management in an… more
    CVS Health (07/31/25)
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  • Utilization Review Clinician…

    Centene Corporation (Tallahassee, FL)
    …in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of ... be located in eastern or central time zone with experience in utilization management .** **Education/Experience:** Requires Graduate of an Accredited School… more
    Centene Corporation (07/31/25)
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  • Utilization Management Nurse

    CenterWell (Tallahassee, FL)
    …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous...and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral more
    CenterWell (08/08/25)
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  • Utilization Management Nurse

    CenterWell (Tallahassee, FL)
    …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous...and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral more
    CenterWell (08/02/25)
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  • Behavioral Health Medical Director…

    Humana (Tallahassee, FL)
    …value-based care, quality metrics, population health , and disease or care management . The Behavioral Health Medical Director may develop procedures, ... part of our caring community and help us put health first** The Behavioral Health ...management , utilization management , case management , discharge planning and/or home health or… more
    Humana (08/09/25)
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  • Utilization Review Clinician - EST/CST…

    Monte Nido (Miami, FL)
    …private payment. 9. Leverage understanding of medical necessity criteria and current behavioral health insurance landscape in verbal and written communications ... the opportunity for people to realize their healthy selves. ** Utilization Review Clinician** **Monte Nido** **Remote - EST or...Assistance Program (EAP) + Flexible Spending Account (FSA) + Health Savings Account (HSA) + Paid time off +… more
    Monte Nido (06/21/25)
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  • Director Behavioral Health

    HCA Healthcare (Fort Walton Beach, FL)
    …eligible. **Introduction** Are you ready to manage in a new era as a Director Behavioral Health where building a healthier tomorrow is more than a job? Our ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free... management , including position control, scheduling excellence, productivity management , and premium pay utilization . Maintains staffing… more
    HCA Healthcare (07/23/25)
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  • Physician (Mental Health ) - Associate…

    Veterans Affairs, Veterans Health Administration (Miami, FL)
    …quality standards, while improving the Veteran's experience and outcomes. Defines mental health policies, utilization management process and procedures, ... Summary Miami VA Healthcare System's Mental Health / Behavioral Science Service is seeking an...goals for eligibility, referral and authorization, care coordination, and utilization management to ensure improved Veteran experience.… more
    Veterans Affairs, Veterans Health Administration (06/28/25)
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  • Hybrid Manager, Care Management

    CenterWell (Tampa, FL)
    …a remote position_** **)** is responsible for managing a team of nurses, community health workers, and behavioral health resources who engage high risk/high ... part of our caring community and help us put health first** The Manager Care/Case Management in... health outcomes. + Accountability to key population health metrics, including quality, utilization and financial… more
    CenterWell (08/08/25)
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