- Humana (Hallandale Beach, FL)
- …and psycho-social health issues. + Monitor and maintain awareness of utilization and conducts outreach based on acuity to assess medical/social/BH needs and ... part of our caring community and help us put health first** Are you a transitioning military service member...for a period up to 11 weeks. + **Workstyle:** Home . Home workstyle is defined as remote… more
- HCA Healthcare (Palm Harbor, FL)
- …**Job Summary and Qualifications** The Director of Employee and Occupational Health for West Florida Division ensures high quality, patient-centered care through ... overall function, staffing, planning, and budget of the Occupational and Employee Health programs. The Director of Employee and Occupational Health facilitates… more
- Ascension Health (Jacksonville, FL)
- …FL This job location is not currently located in a Health Professional Shortage Area (HPSAs) and/or Medically Underserved Areas/Populations (MUA/P) Shortage ... Designation Type. **Benefits** Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term &… more
- Evolent (Tallahassee, FL)
- …the support services review process. Responsible for the quality of utilization review determinations, including appeals. + Provides input into audit ... for select health plans or regions, assuming overall accountability for utilization management while working in conjunction with the SVP, CCO and/or CMO. +… more
- Evolent (Tallahassee, FL)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director.… more
- Elevance Health (Miami, FL)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... - FEP** , a proud member of the Elevance Health , Inc. family of companies, it is a powerful...reviews with attending physicians or other providers to discuss review determinations and patient's office visits with providers and… more
- HCA Healthcare (Gainesville, FL)
- …a data-driven environment of quality and cost improvement and develops systems to review utilization of resources and objectively measure outcomes of care in ... for appeals and denials process, discharge planning, case management, and utilization review /management. + Consults with facility-level staff regarding delegated… more
- Evolent (Tallahassee, FL)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director.… more
- Evolent (Tallahassee, FL)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director.… more
- Humana (Tallahassee, FL)
- …quality management, utilization management, case management, discharge planning and/or home health or post-acute services (such as inpatient rehabilitation). ... insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review organization,… more