- Elevance Health (Miami, FL)
- …members and providers. + Supports coordination with external entities that develop clinical utilization management guidelines used by Company Plans (eg, MCG Care ... guidelines, Carelon Medical Benefits Management guidelines and CarelonRx) + Identifies and develops opportunities...state or territory of the United States when conducting utilization review or an appeals consideration and… more
- HCA Healthcare (Fort Lauderdale, FL)
- …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 medical ... point for application support and will help drive the implementation and utilization of key applications they are assigned. They will understand and assist… more
- CenterWell (Daytona Beach, FL)
- …opportunities for education/coaching + Identifying trends and areas of opportunity in pharmacy utilization (pharmacy management ) to impact Part D per Member per ... Collaborative / Supervisory Agreements per state protocols + Assisting with panel management + Providing direct education to clinicians around clinical protocols /… more
- HCA Healthcare (Kissimmee, FL)
- …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 medical ... through clinical screenings and assessments in collaboration with both hospital Case Management and the Rehab Medical Director. Job Duties and Responsibilities: +… more
- HCA Healthcare (Fort Pierce, FL)
- …self-knowledge and growth. To establish, implement and supervise the activities of the Safety Management Program by: Periodic review and update of all safety ... 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 medical… more
- HCA Healthcare (Tallahassee, FL)
- …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 medical ... through clinical screenings and assessments in collaboration with both hospital Case Management and the Rehab Medical Director. Job Duties and Responsibilities: +… more
- HCA Healthcare (Brandon, FL)
- …and satisfaction. + You will promote cost effectiveness through the integration of case management , utilization review management and discharge planning. ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services...offer many services including a heart & vascular center, behavioral health center and a women's center. Our women's… more
- HCA Healthcare (Trinity, FL)
- …Healthcare Quality) OR CHCQM (Diplomate in American Board of Quality Assurance and Utilization Review Physicians) _Individuals without CPHQ or ABQUARP will be ... 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 medical… more
- HCA Healthcare (Miami, FL)
- … + Experience or 2 years of critical care experience + Certification in case management or utilization review preferred + InterQual experience preferred HCA ... 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 medical… more
- Community Based Care of Brevard, Inc. (Rockledge, 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 ... coordinator will actively participate in, and facilitate, as needed, Local Review Teams and other applicable staffings/meetings. They will document activities and… more
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