- Community Based Care of Brevard, Inc. (Orlando, FL)
- Salary: $65,000/year Position Summary: The UM Program Manager provides oversight and management of service authorization data validation, reporting and trend ... line-by-line entries, and submits to finance for payment. The UM Program Manager reconciles ARGOS Dependency Cases...application for daily entry of case activity and the utilization management of service authorizations. Educational and… more
- Molina Healthcare (Orlando, FL)
- …and quality initiatives under the direction of leadership. * Monitors drug utilization and assists leadership team in understanding quality and cost-control issues ... pharmacy benefit changes for the upcoming year. * Works with the care management department as part of a member-centered interdisciplinary care team (ICT). * Works… more
- Molina Healthcare (Orlando, FL)
- …utilization and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies ... adjustment, disease management , and evidence-based guidelines. + Experience in Utilization /Quality Program management + HMO/Managed care experience… more
- AdventHealth (Orlando, FL)
- …Utilization Management . Serves as an active participating member of the Utilization Management ( UM ) Committee by ensuring committee is actively ... this role educates, informs, and advises members of the Utilization Management , Health Information Management ...succeed** **:** + Graduate from medical school and residency program + 5 Recent clinical practice Required + MD… more
- AdventHealth (Orlando, FL)
- …and serves as a resource to Medical Staff colleagues regarding best practices, Utilization Management and Care Management structures, and functions and ... Days Off from Day One + Student Loan Repayment Program + Career Development + Whole Person Wellbeing Resources...productive internal/external relationships with all physicians and constituents of Utilization Management , Care Management and… more
- Molina Healthcare (Orlando, FL)
- …experience as a Medical Director in clinical practice * 3 years' experience in Utilization /Quality Program Management * 2+ years HMO/Managed Care experience ... **Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental… more
- Molina Healthcare (Orlando, FL)
- …with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. **Required Qualifications** ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more
- Molina Healthcare (Orlando, FL)
- …MI_** **Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental ... substance use services and assists with implementing integrated Behavioral Health care management programs. **Job Duties** * Serves as liaison between plan and… more
- Molina Healthcare (Orlando, FL)
- …with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. **Required Qualifications** ... and verbal communication skills. * Microsoft Office suite/applicable software program (s) proficiency. **Preferred Qualifications** * Certified Professional in Healthcare… more