- Actalent (Sunrise, FL)
- Utilization Management Behavioral Health ClinicianUtilization Management Behavioral Health Clinician We're seeking a dedicated Behavioral ... Health Clinician to join our Utilization Management team. In this role, you'll collaborate with an...Conduct utilization reviews and service authorizations for behavioral health and substance use treatments. +… more
- Actalent (Sunrise, FL)
- … Behavioral Health Utilization Review Specialist conducts comprehensive utilization management activities for behavioral health plan members. ... Job Title: Behavioral Health Utilization Review...assigned. Essential Skills + Proficiency in clinical review and utilization management . + Knowledge of Interqual and… more
- Actalent (Sunrise, FL)
- Utilization Management Nurse!Job Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing service authorization requests to ... activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management ...employee and dependents) * Short and long-term disability * Health Spending Account (HSA) * Transportation benefits * Employee… more
- Centene Corporation (Tallahassee, FL)
- …in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of ... licensed and located in FL. Ideal candidate will have experience in Utilization Management .** **Education/Experience:** Requires Graduate of an Accredited School… more
- Elevance Health (Miami, FL)
- **JR153784 Behavioral Health Care Manager II** The Behavioral Health Care Manager II is a utilization management role and is responsible for ... utilization management review for Behavior Analysis services. **Location** : Virtual:...resources. + Will serve as a resource to other Behavioral Health Care Managers. + Assists with… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …safe discharge coverage for all hospital units. + Participates in utilization management initiatives/opportunities for improvement through departmental committee ... to appropriate level of care. + Collaborates with family, health care team, payors, and providers to achieve appropriate...Florida. + 3 years minimum experience in discharge planning, utilization management , or case management .… more
- Monte Nido (Miami, FL)
- …private payment. 9. Leverage understanding of medical necessity criteria and current behavioral health insurance landscape in verbal and written communications ... the opportunity for people to realize their healthy selves. ** Utilization Review Clinician** **Monte Nido** **Remote - EST or...Assistance Program (EAP) + Flexible Spending Account (FSA) + Health Savings Account (HSA) + Paid time off +… more
- Elevance Health (Tampa, FL)
- ** Behavioral Health Care Manager II** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... and ensures essential face-to-face onboarding and skill development. The ** Behavioral Health Care Manager II** is responsible...is licensed staff supervision. + Previous experience in case management / utilization management with a broad… more
- Centene Corporation (Tallahassee, FL)
- …including a fresh perspective on workplace flexibility. **Centene is Hiring: Remote Behavioral Health Clinical Liaison (Florida)** **Centene is seeking a ... Behavioral Health Clinical Liaison to join our Sunshine ...the continuum of care. Experience with managed care, case management , utilization management , or quality… more
- Cleveland Clinic (Vero Beach, FL)
- …career with one of the most respected healthcare organizations in the world. As a Behavioral Health Technician, you will provide direct care to behavioral ... and supportive environment and ensure accurate documentation in patient charts. Our behavioral health professionals are dedicated to supporting patients through… more
- MyFlorida (Alachua, FL)
- BEHAVIORAL SPECIALIST - 60004817 Date: Jun 19, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 854792 Agency: Children and Families Working Title: BEHAVIORAL SPECIALIST - 60004817 Pay Plan: Career Service Position Number: 60004817… more
- Veterans Affairs, Veterans Health Administration (West Palm Beach, FL)
- …various Medical Center committees; serving as the back-up Physician Utilization Management Advisor (PUMA) for Mental Health ; assists as needed with arranging ... clinical and administrative direction of the Assistant Chief, Mental Health & Behavioral Science Service, will oversee... Science Service, will oversee many aspects of mental health resource utilization , such as use of… more
- CenterWell (Tallahassee, FL)
- … in **Palm Beach/TC area** is responsible for managing a team of nurses, community health workers, and behavioral health resources who engage high risk/high ... health outcomes. + Accountability to key population health metrics, including quality, utilization and financial...and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral … more
- CVS Health (Miami, FL)
- …care management activities with members to ensure that their medical and behavioral health needs are met and to enhance the member's overall wellness. ... + Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate… more
- Florida Health Care Plans, Inc. (Edgewater, FL)
- …assessment, and treatment of Behavioral Health patients + Case Management functions + Utilization Management functions. + Special Projects functions ... , no weekends. Some of our larger multi-specialty hubs offer Behavioral Health , Diabetes Education, EHCC Walk In, Endocrinology, Lab, Primary Care, Pharmacy,… more
- Highmark Health (Tallahassee, FL)
- …Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health care services, ... utilization , identification of opportunities for referral to a Health Coach/case management , and identification and resolution...position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Bluestone Physician Services (Orlando, FL)
- …determinants of health , manage transitions to and from inpatient settings, provide behavioral health support and more. Under our model of care, Bluestone ... with primary care teams to ensure high quality team-based care + Use utilization management tools to facilitate appropriate transitional care management … more
- Elevance Health (West Palm Beach, FL)
- …member's circle of support and overall management of the individuals physical health (PH)/ behavioral health (BH)/LTSS needs, as required by applicable ... associates, and may be involved in process improvement initiatives. + Submits utilization /authorization requests to utilization management with documentation… more
- Elevance Health (FL)
- …patients, patients with IDD and patients with special needs is preferred. + Home Health , Utilization Management or Case Management experience strongly ... care plans by educating members regarding clinical needs and facilitating referrals to health professionals for behavioral health needs. + Uses motivational… more
- HCA Healthcare (Tallahassee, FL)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed ... you have the career opportunities as a(an) Manager Case Management you want in your current role? We invest...Leon and Gadsden Counties. Our facilities include a state-of-the-art Behavioral Health Center, Cancer Center, Chest Pain… more