- CVS Health (FL)
- …No weekends or holidays. + 1+ years of utilization review/ utilization management required. + 3+ years of behavioral health clinical experience in a ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable… more
- Molina Healthcare (St. Petersburg, FL)
- …with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At ... of KY and or compact licensure The Care Review Clinician Inpatient Review BH will provide prior authorization for...for outpatient and inpatient services for the KY Medicaid behavioral health population. Strong post-acute level of care experience… more
- Highmark Health (Tallahassee, FL)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more
- CenterWell (Daytona Beach, FL)
- …in patient experience, quality of care, clinical outcomes, and avoidable utilization *Periodically review clinician charts to identify opportunities in ... our primary care team, combining clinical practice with leadership and operational management to ensure high-quality patient care and alignment with Value-Based Care… more
- CenterWell (Jacksonville, FL)
- …performance in patient experience, quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify opportunities ... our primary care team, combining clinical practice with leadership and operational management to ensure high-quality patient care and alignment with Value-Based Care… more
- CenterWell (Tallahassee, FL)
- …areas as financial performance, incentive programs, quality and clinical management , population health, data sharing, connectivity, documentation and coding, HEDIS ... operational improvements and other areas as they relate to practice and clinician performance, patient experience, market growth, practice and clinician … more
- Magellan Health Services (Pensacola, FL)
- …- Driver License, Valid In State - OtherOther, Must be an independently licensed behavioral health clinician - Care MgmtCare Mgmt License and Certifications - ... wellness presentations, and consultation to the assigned brigade/regiments command regarding behavioral health issues with a unique understanding of the military… more