- 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
- 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 (Miami, 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
- 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
- Elevance Health (Miami, 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 (Coral Gables, FL)
- …identification, evaluation, coordination and management of member's needs, including physical health , behavioral health , social services and long term ... care team, to ensure cost effective and efficient utilization of health benefits. + Decision making...+ Bilingual in Spanish strongly preferred. + Previous case management or oncology experience strongly preferred. + Experience using… more
- Vighter Medical Group (Miami, FL)
- …but not required. Knowledge, Skills, & Abilities: + Implements and evaluates behavioral health assessments and interventions in accordance with the polices ... the delivery of healthcare services to persons in custody. + Provide Operational Behavioral Health (BH) advice, support, and coordination to Sector leadership… more
- HCA Healthcare (Sunrise, 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 ... Chain, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...expense, clinical integration, quality, and service + Execute clinical utilization and expense management plans and ensure… more
- Molina Healthcare (Miami, FL)
- …facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need ... Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines.… more
- HCA Healthcare (Miami, 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 ... labor management , including position control, scheduling excellence, productivity management , and premium pay utilization . Maintains staffing to ensure… more
- Molina Healthcare (Miami, FL)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... transplants; the ideal candidate will have experience either in utilization review or case management for transplants. Preference will be given to those whose… more
- HCA Healthcare (Plantation, 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 ... Hospital, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...years of critical care experience + Certification in case management or utilization review preferred + InterQual… more
- HCA Healthcare (Miami, 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 ... Hospital, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...years of critical care experience + Certification in case management or utilization review preferred + InterQual… more
- HCA Healthcare (Aventura, 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 ... labor management , including position control, scheduling excellence, productivity management , and premium pay utilization . Maintains staffing to ensure… more
- HCA Healthcare (Aventura, 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 ... Hospital, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...etc.) hospital nursing experience required + Certification in case management or utilization review preferred + InterQual… more
- HCA Healthcare (Aventura, 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 ... Hospital, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...etc.) hospital nursing experience required + Certification in case management or utilization review preferred + InterQual… more