Utilization Manager Jobs in Florida
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Search Results - Utilization Manager Jobs in Florida
GuideWell Mutual Holding Corporation-Jacksonville
Locations United States FL, United States (Remote)
Job Description
The Medical Director will work closely with the team to perform all types of utilization management (UM) reviews, including but not limited to Pre-service, Post-service...
appcast.io -
2 similar jobs: Tampa, Miami
Leesburg (FL)
required)
Evaluates patient medical records to determine the medical necessity and appropriateness of healthcare services in alignment with utilization management guidelines. Collaborates with healthcare providers to support compliance, optimize treatment...
ufhealth.org -
Centene Management Company LLC-Miami
Centene Management Company LLC is seeking a Medical Director to lead medical management, quality improvement, and credentialing for the unit. The role provides medical leadership for utilization management, cost containment and quality initiatives...
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Black Book-Tampa
advisor to payer and healthcare leaders, helping them address challenges across care management, utilization management, member administration, pharmacy, quality, compliance, complaints, appeals and grievances, interoperability, workflow automation...
1 similar job: Madison
Centene Management Company LLC-Jacksonville
Centene Management Company LLC is seeking a Medical Director to lead medical management, quality improvement, and credentialing for the unit. The role provides medical leadership for utilization management, cost containment and quality initiatives...
appcast.io -
Randstad-Tampa
in Florida! Save time and money by ditching the daily commute and working comfortably from your own home office.
In this vital role, you will serve as a key resource in the utilization management process, ensuring authorization requests are handled...
randstadusa.com -
Centene Management Company LLC-Tampa
Centene Management Company LLC is seeking a Medical Director to lead medical management, quality improvement, and credentialing for the unit. The role provides medical leadership for utilization management, cost containment and quality initiatives...
appcast.io -
Optum-Clearwater
in the agency's utilization management model
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#LHCjobs
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You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide...
1 similar job: Dushore
Molina Healthcare-Naples (FL)
Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
• Provides behavioral health oversight and clinical leadership for health plan and/or market specific utilization management and care management...
appcast.io -
Optum-Fernandina Beach
in the agency's utilization management model
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• Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client
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You'll be rewarded and recognized for your performance...
1 similar job: Palatka
eMed, LLC-Miami
requirements involving:
• PBM integration
• Pharmacy carve-outs
• Formulary strategy
• Prior authorization and utilization management
• Specialty and high-cost medications
• GLP-1 management
• Member eligibility
• Accumulator integration
• Claims...
Optum-Winter Haven
safety, and implements processes and best practices to ensure positive patient outcomes
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• Participates in on-call and weekend rotation as needed to meet patient needs
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• Adheres to and participates in the agency's utilization management model
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1 similar job: Fort Myers
Fort Myers
such as preparation of expense reports and maintaining petty cash and receipts
• Assist the HSA and DON with recruiting efforts, credentialing, scheduling interviews, and processing new hire documentation
• Utilization management to include processing offsite...
icims.com -
Gainesville
to the most appropriate level of care.
Qualifications:
Minimum Education and Experience Requirements: BSW, Bachelor's degree, or LPN required;
Screening and assessment skills and expertise in care coordination and/or utilization management in a health care...
ufhealth.org -
Orlando
to benefit from care coordination services to include assessing patients' risk factors and the need for care coordination, clinical utilization management and preventative care services.
Responsibilities:
Essential Functions
• Takes the lead...
orlandohealth.com -
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