- Evolent (Tallahassee, FL)
- …driving results, and collaborating with others. **Collaboration Opportunities:** + The Manager , Client Services oversees daily utilization management and directs ... health plans and serves in a supporting role to the Director, Intake and Utilization Management Operations. + This individual will not only lead a production team… more
- CenterWell (Tampa, FL)
- …for managing populations and coordinating care to reduce acute and post-acute care utilization . The Manager role is hybrid with travel requirements to preferred ... caring community and help us put health first** The Manager Care/Case Management in **Tampa area (** **_this is...action plans that will reduce acute and post-acute care utilization . + Solicits/shares feedback with market leaders on team-based… more
- Healthfirst (FL)
- The Case Manager , Utilization Management coordinates the care plan for assigned members and conducts pre-certification, concurrent review, discharge planning, ... and case management as assigned. The Case Manager , Utilization Management is also responsible for efficient utilization of health services and optimal health… more
- AdventHealth (Riverview, FL)
- …predictable results. Communicate with OR leadership and physicians as appropriate on utilization . The Business Manager fosters the integration of the ... care. **The role you'll contribute** **:** The Surgical Services Business Manager has financial accountability, authority and responsibility for AdventHealth. The… more
- Select Medical (Panama City, FL)
- …high-quality care and doing well by doing what is right. The Case Manager is responsible for utilization reviews and resource management, discharge planning, ... **Overview** **Critical Illness Recovery Hospital** **Case Manager (PRN)** _Requires a current licensure in a...safe and timely discharge plan. + Performs verification of utilization criteria reviews. + Builds relationships and coordinate with… more
- Select Medical (Orlando, FL)
- …high-quality care and doing well by doing what is right. The Case Manager is responsible for utilization reviews and resource management, discharge planning, ... **Overview** **Critical Illness Recovery Hospital** **Case Manager ** _Requires a current licensure in a clinical...safe and timely discharge plan. + Performs verification of utilization criteria reviews. + Builds relationships and coordinate with… more
- Humana (Tallahassee, FL)
- …part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 + Clinical knowledge, communication skills, and… more
- CenterWell (Tallahassee, FL)
- …of our caring community and help us put health first** The Utilization Management (UM) Administrative Coordinator 2 is responsible for providing high-quality support ... service or customer service telephone experience desired + Experience with Utilization Review and/or Prior Authorization, preferably within a managed care… more
- CenterWell (Tallahassee, FL)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare +… more
- CenterWell (Tallahassee, FL)
- …Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare/Medicaid… more