Utilization Manager Jobs in Jacksonville
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Search Results - Utilization Manager Jobs in Jacksonville
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 -
Optum-Jacksonville
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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• Ability...
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...
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Jacksonville
Qualifications
• Utilization Management (UM) experience.
• Experience utilizing InterQual Criteria.
• Medical record abstracting skills.
Why us?
We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals...
acentra.com -
Centene Management Company LLC-Jacksonville
Position Purpose
Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. Provides medical leadership of all for utilization management, cost...
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Jacksonville
AND- 3-5 years of Utilization management, case management and/or discharge planning experience and experience in a hospital setting.
Preferred Experience: Experience working in an academic medical center. Supervision: Supervisory responsibility of 20-30...
ufhealth.org -
GuideWell-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 -
StaffMED Health Partners, LLC-Jacksonville
StaffMed Health Partners seeks a board certified Physician Advisor to join the leadership team in Southeast Florida. This is a non-clinical, on-site, full-time role influencing utilization management, documentation integrity, and physician education...
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Staffmed Healthcare Staffing & Recruiting (Medical Edge Recruitment)-Jacksonville
that has a major impact and influence over utilization management, documentation integrity, and physician education to improve patient care and hospital performance.
Roles and Responsibilities
• Review cases for appropriate Level of Care and monitor...
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Sound Physicians-Jacksonville
performance, and a culture of collaboration. Whether managing complex cases or optimizing hospital workflows, our hospitalists are empowered to make a lasting impact, supported by systems that prioritize autonomy, accountability, and continuous improvement...
MyCare-Jacksonville
improvement initiatives focused on clinical excellence and value-based care.
• Population Health: Support proactive management of high-risk patients and chronic conditions.
• Utilization Management: Drive initiatives to reduce avoidable hospital admissions...
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Nemours Children's Health-Jacksonville
serve in many leadership roles in the hospital, residency program, utilization management, and clinical operations. Faculty are part of the VIP network and are involved in multi-site projects.
Candidates must be board-certified or board-eligible...
CO010 Memorial Healthcare System-Jacksonville
It is the foundation of The Memorial Experience. Summary: The Medical Director of Case Management and Utilization Review leads the hospital specific execution of the Case Management (CM) and Utilization Management (UR) and related activities.
The Medical Director...
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CMP01 Mount Sinai Medical Center of Florida, Inc.-Jacksonville
living facilities, participants’ homes, and other settings. Support timely discharge planning, medication reconciliation, post‑discharge follow‑up, and safe transitions of care.
Utilization and Medicare Risk Management:
Support appropriate utilization...
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