Utilization Manager Jobs in Miami
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Search Results - Utilization Manager Jobs in Miami
GuideWell Mutual Holding Corporation-Miami
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...
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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...
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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Miami
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 -
GuideWell-Miami
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 -
Centene Corporation-Miami
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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MyCare-Miami
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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StaffMED Health Partners, LLC-Miami
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)-Miami
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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CO010 Memorial Healthcare System-Miami
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.-Miami
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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