- Humana (Tallahassee, FL)
- …first** The UM Administration Coordinator 2 contributes to administration of utilization management . The UM Administration Coordinator 2 performs varied ... assignments. Performs computations. Typically works on semi-routine assignments. The UM Administration Coordinator 2 provides non-clinical support for the policies… more
- Humana (Tallahassee, FL)
- …a part of our caring community and help us put health first** The UM ( Utilization Management ) Administration Coordinator 2 contributes to administration of ... utilization management . We focus on living out our values daily...eligible dependents Parental and caregiver leave Employee charity matching program Network Resource Groups (NRGs) Career development opportunities **Social… more
- Molina Healthcare (FL)
- …with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. **Required Qualifications** ... surgical, emergency room, intensive care unit, or in a telemetry type setting. UM medical review experience highly preferred. Work Hours: Monday - Friday 8:00am-… more
- Molina Healthcare (Orlando, FL)
- …chief medical officer on denial decisions. * Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. * ... to provide quality and cost-effective member care. Candidates with UM and Appeals experience are highly preferred Work hours:...be required. * Serves as a clinical resource for utilization management , chief medical officer, physicians, and… more
- CenterWell (Tallahassee, FL)
- …**Additional Information** Will report to the Director of Physician Strategy at Utilization Management . The Medical Director conducts Utilization review ... work, communication of decisions to internal associates, participation in care management and possible participation in care facilitation with hospitals. The… more
- Centers Plan for Healthy Living (Margate, FL)
- …with the guidance and plans they need for healthy living. JOB SUMMARY: The Utilization Management Care Coordinator works within a multidisciplinary care team to ... the care of members enrolled in our Managed Long Term Care program and facilitate authorization requests for eligible members. PRIMARY RESPONSIBILITIES: + Assists… more
- Veterans Affairs, Veterans Health Administration (Miami, FL)
- …The Miami VA medical Center is looking for recruit for Registered Nurse - Utilization Management / Float who is responsible and accountable for all elements ... offers a comprehensive total rewards package: VA Nurse Total Rewards The Utilization Management /Float Registered Nurse is located at the Nursing, Perioperative… more
- CenterWell (Tallahassee, FL)
- …managing healthcare utilization , ensuring efficient and effective processes within the UM program . Key Responsibilities of a Non-Clinical UM Coordinator: ... **Become a part of our caring community and help us put health first** Utilization Management Administration Coordinator II , non-clinical, supports the UM … more
- Molina Healthcare (Miami, FL)
- …utilization and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies ... adjustment, disease management , and evidence-based guidelines. + Experience in Utilization /Quality Program management + HMO/Managed care experience… more
- Community Health Systems (Naples, FL)
- … of hospital services, escalating cases as needed to the Physician Advisor or Utilization Management ( UM ) committee. + Identifies avoidable hospital days and ... Dental, Vision) **Job Summary** The Care Manager - LPN supports effective utilization management and discharge planning by coordinating patient care activities… more