- AdventHealth (Land O' Lakes, FL)
- …for one another and respect for each persons unique contributions, provides utilization review care that is non-judgmental and non-discriminatory. Consider ... frames on a specific group of patients.The Case Manager is responsible for utilization reviews and resource management , discharge planning, treatment plan … more
- Travelers Insurance Company (Tallahassee, FL)
- …skills **What is a Must Have?** + Licensed MD + 5 years clinical and utilization management experience + Certified by the American Board of Medical Specialties ... to keep Travelers at the leading edge of the P&C industry. Develop medical management strategies that help injured employees return to work as soon as medically… more
- MTC (Quincy, FL)
- …performing the duties of the position. 11. Practice advanced cost containment and utilization management for inmate care and facility operations. 12. Maintain ... and military leave + Opportunities for job advancement Impact lives with Management & Training Corporation (MTC)! At the **Gadsden Correctional Facility in Quincy,… more
- AdventHealth (Maitland, FL)
- …key revenue cycle stakeholders, including but not limited to, medical directors, utilization management leaders and equivalent representatives from the health ... FL **The role you will contribute:** This position is responsible for contract review and interpretation; as well as, the building and maintenance of rates and… more
- AdventHealth (Maitland, FL)
- …and resolve financial and operational issues related to accounts receivable, utilization management , quality assurance, billing, pre-access, care management ... and mid-level tier payer contracts as well as direct and indirect negotiation, review , and completion of assigned low-level tier payer contracts. Duties as assigned… more
- Molina Healthcare (Jacksonville, FL)
- …file review standards and surveyor interactions. + Experience with conducting Utilization Management and Population Health Management file audits, ... system analysis and program staff. These positions' primary focus is project/program management . **Job Duties** **Program Oversight & Project Management ** +… more
- Prime Therapeutics (Tallahassee, FL)
- …formularies, including items such as manufacturer and GPO negotiation, rate and utilization management policy creation and interpretation, formulary modeling and ... internal and external stakeholders. This position is also responsible for the management of the Trade Client Strategy government programs team, which is responsible… more
- MTC (Graceville, FL)
- …record or other forms as appropriate. + Practice basic cost containment and utilization management for inmate care and facility operations. + Maintain absolute ... HIPAA rules. + Accurately and promptly chart medical care. Review medical files to determine all provided services are...with an acceptable driving record required, unless waived by management . Management & Training Corporation (MTC) is… more
- MTC (Graceville, FL)
- …record or other forms as appropriate. + Practice basic cost containment and utilization management for inmate care and facility operations. + Maintain absolute ... HIPAA rules. + Accurately and promptly chart medical care. Review medical files to determine all provided services are...with an acceptable driving record required, unless waived by management . Management & Training Corporation (MTC) is… more
- Prime Therapeutics (Tallahassee, FL)
- …specific clinical programs and drug strategy recommendations including drug formulary, Utilization Management programs, and other drug therapy related products ... stakeholders through effective consultative services. **Responsibilities** + Coordinate formulary management for the client including, client specific Pharmacy &Therapeutics… more