• Utilization Management

    Humana (Tallahassee, FL)
    …a part of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
    Humana (01/10/26)
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  • Medical Director, Behavioral Health

    Molina Healthcare (Jacksonville, FL)
    …chemical dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and ... and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and… more
    Molina Healthcare (01/06/26)
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  • Senior Medical Director, Behavioral

    Molina Healthcare (Orlando, FL)
    …while contributing to enterprise-wide strategies for integrated behavioral health programs, utilization management standardization, and cost-effective ... psychiatric leadership and clinical expertise for utilization management , case management , and integrated behavioral health /chemical dependency… more
    Molina Healthcare (01/01/26)
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  • Behavioral Health Care Manager I

    Elevance Health (Tampa, FL)
    …abuse cases preferred. ​ **Preferred Skills, Capabilities and Experiences:** + Experience in behavioral health utilization management is highly ... Behavioral Health Care Manager I- ... Behavioral Health Care Manager I- Behavioral ...there is licensed staff supervision. Previous experience in case management / utilization management with a broad… more
    Elevance Health (01/10/26)
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  • Coordinator, Intake Utilization

    Evolent (Tallahassee, FL)
    …the mission. Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for ... and client contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, … more
    Evolent (01/06/26)
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  • Utilization Review Coordinator

    Devereux Advanced Behavioral Health (Viera, FL)
    … Review Coordinator at Devereux has its Advantages!** Devereux Florida is a nonprofit behavioral health organization that provides a wide range of services for ... you looking to advance your career in Admissions & Utilization Review? If you answered yes, then consider joining...**_Position Type_** _Full-Time_ The employment policies of Devereux Advanced Behavioral Health are to recruit and hire… more
    Devereux Advanced Behavioral Health (01/02/26)
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  • Pharmacist - Utilization Management

    Highmark Health (Tallahassee, FL)
    …coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by ... prior authorization or appeals against medical policy through the Utilization Review system. Update the system records appropriately to...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
    Highmark Health (12/30/25)
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  • Behavioral Health Nurse - Managed…

    DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
    management , or utilization review setting + Strong understanding of behavioral health diagnoses, treatments, and psychotropic medications + Knowledge of ... Position is On-Site The Behavioral Health Nurse - Managed Care...it pertains to patient admission/safe discharge. + Participates in utilization management initiatives/opportunities for improvement through departmental… more
    DOCTORS HEALTHCARE PLANS, INC. (01/01/26)
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  • Behavioral Health Care Manager II…

    Elevance Health (FL)
    ** Behavioral Health Care Manager II -...requirement for this position. + Previous experience in case management / utilization management with a broad ... the Elevance Health family of companies, **Carelon Behavioral Health ** , offers superior clinical mental... Health ** , offers superior clinical mental health and substance use disorder management , a… more
    Elevance Health (01/09/26)
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  • Behavioral Health Care Manager…

    Elevance Health (Tampa, FL)
    ** Behavioral Health Care Manager I (3rd Shift - After Hours)** **Virtual:** This role enables associates to work virtually full-time, except for required ... the Elevance Health family of companies, Carelon Behavioral Health , formerly Beacon Health ...Skills, Capabilities and Experiences:** + Previous experience in case management / utilization management with a broad… more
    Elevance Health (01/09/26)
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