- Elevance Health (Miami, FL)
- …+ Provides guidance for clinical operational aspects of a program. + Perform utilization management reviews to determine medical necessity and appropriateness of ... an equivalent background. + For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years of experience providing … more
- CVS Health (FL)
- …with the Behavioral Health , Pharmacy, Member Outreach, Care Management , National Quality Management , Utilization Management , Compliance, ... health outcomes. * Leverage extensive knowledge of health care delivery system, utilization management...departments to integrate social, behavioral , and physical health and improve clinical program execution. * In collaboration… more
- Bluestone Physician Services (Tampa, FL)
- …determinants of health , manage transitions to and from inpatient settings, provide behavioral health support and more. Under our model of care, Bluestone ... with primary care teams to ensure high quality team-based care + Use utilization management tools to facilitate appropriate transitional care management … more
- Elevance Health (Tallahassee, FL)
- …member's circle of support and overall management of the individuals physical health (PH)/ behavioral health (BH)/LTSS needs, as required by applicable ... associates, and may be involved in process improvement initiatives. + Submits utilization /authorization requests to utilization management with documentation… more
- Elevance Health (FL)
- …law._ The **Medical Director** is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... an equivalent background. * _For Health Solutions and Carelon organizations (including behavioral health ) only, a minimum of 5 years of experience providing … more
- HCA Healthcare (Tallahassee, FL)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed ... you have the career opportunities as a(an) Manager Case Management you want in your current role? We invest...Leon and Gadsden Counties. Our facilities include a state-of-the-art Behavioral Health Center, Cancer Center, Chest Pain… more
- Ascension Health (Jacksonville, FL)
- …promote and oversee patient safety, continuous performance and quality improvement, risk management and efficient resource utilization . + Provides leadership to ... but not limited to; + Quality and Safety + Utilization Review + Peer Review and Credentialing + Growth...within the context of a multi-site and growing regional health system. + A management style which… more
- Sharecare (Tallahassee, FL)
- …members to become empowered and active participants in their own healthcare management for their chronic condition. By providing health education and ... **Job Description:** Sharecare is the leading digital health company that helps people - no matter...nurse helps to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management… 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 ... (DO) **Substitutions** + None **Preferred** + Master's Degree in Business Administration/ Management or Public Health **EXPERIENCE** **Required** + 5 years… more
- HCA Healthcare (Inverness, FL)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed ... organization that invests in you as a Director Case Management ? At HCA Florida Citrus Hospital, you come first....Hospital offers a total rewards package that supports the health , life, career and retirement of our colleagues. The… more