- Centene Corporation (Tallahassee, FL)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall… more
- Centene Corporation (Tallahassee, FL)
- …assess ABA Treatment Plans preferred. Knowledge of ABA services and BH utilization review process preferred. Experience working with providers and healthcare ... and/or have obtained the state required licensure as outlined by the applicable state required. Behavioral health clinical knowledge and ability to review and/or… more
- Molina Healthcare (Tampa, FL)
- …reliable transportation. **Preferred Experience** Previous experience in ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of ... plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS… more
- Molina Healthcare (Miami, FL)
- …in good standing Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / ... plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS… more
- Molina Healthcare (FL)
- **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in United States who has a compact, multi-state license. This team reviews the prior ... transplants; the ideal candidate will have experience either in utilization review or case management for transplants....an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high… more
- CenterWell (Tallahassee, FL)
- …consistent and standardized program workflows, dyad communication/partnership, and quarterly business review of acute care and post-acute care utilization . + ... and coordinating care to reduce acute and post-acute care utilization . The Divisional Director role is a hybrid with...credible leader with deep understanding and empathy for the clinician and patient pain points in day-to-day panel management… more