- Actalent (Sunrise, FL)
- Utilization Management Behavioral Health ClinicianUtilization Management Behavioral Health Clinician We're seeking a dedicated Behavioral ... Health Clinician to join our Utilization Management team. In this role, you'll collaborate with an...Conduct utilization reviews and service authorizations for behavioral health and substance use treatments. +… more
- Centene Corporation (Tallahassee, FL)
- …in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of ... licensure as outlined by the applicable state required. Master's degree for behavioral health clinicians required. Clinical knowledge and ability to review… more
- CVS Health (Tallahassee, FL)
- …we do it all with heart, each and every day. **Position Summary** The Behavioral Health Liaison directs coordination of care between the Aetna benefits member, ... clinical care teams, and providers. The Behavioral Health Liaison conducts both live member...clinician support as required including working with the Care Management and Utilization Management teams.… more
- CenterWell (Tallahassee, FL)
- …UM Administration Coordinator - Phone Intake contributes to administration of utilization management . The UM Administration Coordinator performs varied ... best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …safe discharge coverage for all hospital units. + Participates in utilization management initiatives/opportunities for improvement through departmental committee ... to appropriate level of care. + Collaborates with family, health care team, payors, and providers to achieve appropriate...Florida. + 3 years minimum experience in discharge planning, utilization management , or case management .… more
- Monte Nido (Miami, FL)
- …private payment. 9. Leverage understanding of medical necessity criteria and current behavioral health insurance landscape in verbal and written communications ... the opportunity for people to realize their healthy selves. ** Utilization Review Clinician** **Monte Nido** **Remote - Pacific hours**...Assistance Program (EAP) + Flexible Spending Account (FSA) + Health Savings Account (HSA) + Paid time off +… more
- CenterWell (Tallahassee, FL)
- …engagement, improving provider capacity by reducing administrative work related to population health management , and assisting patients with the aim of improving ... advocate for improving clinician and patient experience and effectiveness through panel management (aka population health management ) + Comfortable managing… more
- Veterans Affairs, Veterans Health Administration (West Palm Beach, FL)
- …various Medical Center committees; serving as the back-up Physician Utilization Management Advisor (PUMA) for Mental Health ; assists as needed with arranging ... clinical and administrative direction of the Assistant Chief, Mental Health & Behavioral Science Service, will oversee... Science Service, will oversee many aspects of mental health resource utilization , such as use of… more
- CVS Health (Doral, FL)
- …care management activities with members to ensure that their medical and behavioral health needs are met and to enhance the member's overall wellness. ... + Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate… more
- CenterWell (Tallahassee, FL)
- … in **Palm Beach/TC area** is responsible for managing a team of nurses, community health workers, and behavioral health resources who engage high risk/high ... health outcomes. + Accountability to key population health metrics, including quality, utilization and financial...and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral … more