- Monte Nido (Miami, FL)
- …lives while providing the opportunity for people to realize their healthy selves. ** Director of Utilization Management** **Monte Nido** **Remote** Monte Nido has ... an intimate home setting. We are looking for a Director of Utilization Management to oversee the... of Utilization Management to oversee the Utilization Management/ Review team and function. This role… more
- Actalent (Fort Lauderdale, FL)
- Actalent is Hiring a Behavioral Health Utilization Review Nurse Job Description We are seeking a dedicated Utilization Management Nurse (UMN) who will work ... cases, internal process development, and provide education to the team on utilization review -related issues. Responsibilities + Review prior authorization… more
- Actalent (Sunrise, FL)
- Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing requests for ... collaboration with the interdisciplinary team, the UMN handles tasks related to utilization review across various specialties, medical treatments, and services.… more
- Elevance Health (Miami, FL)
- …members. The medical director provides clinical expertise in all aspects of utilization review and case management. Provides input on the clinical relevance ... Day to day clinical responsibilities means that the medical director is directly involved in Utilization Management...state or territory of the United States when conducting utilization review or an appeals consideration and… more
- Molina Healthcare (Miami, FL)
- …and interacts with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource ... management. + Develops and implements a Utilization Management program and action plan, which includes strategies...(QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
- Elevance Health (Miami, FL)
- …Plans, Freedom Health, and Optimum Healthcare Plans and will be responsible for utilization review case management for these markets. May be responsible for ... **Medical Director - Florida Medicare Plans** Location: This role enables...state or territory of the United States when conducting utilization review or an appeals consideration and… more
- Molina Healthcare (Miami, FL)
- … director in a managed care organization setting supporting utilization management/quality program management, or equivalent combination of relevant education and ... oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical… more
- HCA Healthcare (Coral Springs, FL)
- …satisfaction and personal growth, we encourage you to apply for our Division Director Clinical Pharmacy Services opening. We promptly review all applications. ... We care like family! Jump-start your career as a(an) Division Director Clinical Pharmacy Services today with HealthTrust Supply Chain. **Benefits** HealthTrust… more
- Molina Healthcare (Miami, FL)
- …Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental health and chemical ... Health care management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization management and case management programs for mental health… more
- University of Miami (Miami, FL)
- …QI training + Improving patient satisfaction + Improving patient safety + Peer review , performance improvement, utilization review , root cause analysis, and ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Department of… more
- HCA Healthcare (Miami, FL)
- …personal growth, we encourage you to apply for our Assistant Supply Chain Director opening. We promptly review all applications. Highly qualified candidates will ... care like family! Jump-start your career as a(an) Assistant Supply Chain Director today with HCA Florida Kendall Hospital. **Benefits** HCA Florida Kendall Hospital… more
- Molina Healthcare (Miami, FL)
- …oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical ... working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and… more
- University of Miami (Miami, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Executive ... department of Facilities has an exciting opportunity for a Full Time Executive Director , Utilities Energy Management to work at the UHealth Medical Campus. The… more
- Elevance Health (Miami, FL)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... employment, unless an accommodation is granted as required by law. The **Medical Director -Dermatology Appeals** is responsible for the review of appeals for… more
- University of Miami (Miami, FL)
- …marketing initiatives through online, social media and patient outreach to ensure full utilization of programs. + Review /apply for related funding and grant ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The University of… more
- University of Miami (Miami, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The UHealth ... Miami has an exciting opportunity for a Full Time Director of Pharmacy at our LENNAR location. The ...quality patient care while promoting fiscal responsibility in the utilization of resources. Within the scope of budget responsibilities,… more
- Elevance Health (Miami, FL)
- … Director ** **Carelon Medical Benefits Management** **Radiology Benefit** **Management/ Utilization ** ** Review ** **Virtual:** This role enables associates to ... attention, any case review decisions that require + Medical Director review or policy interpretation. **Minimum Requirements:** + Requires MD or DO and… more
- Elevance Health (Miami, FL)
- …their supervisors attention, any case review decisions that require Medical Director review or policy interpretation. + Determine medical necessity of ... **Clinical Operations Medical Director ** **Carelon MBM** **Virtual:** This role enables associates...CMS Coverage Determinations, as applicable. + Perform physician-level case review of utilization requests for procedures and… more
- ChenMed (Margate, FL)
- …rapidly expanding and we need great people to join our team. The Medical Director , Center is specifically responsible for executing the ChenMed Way and core model in ... the direction of the Market Chief Medical Officer (MCMO), the Medical Director , Center will directly supervise, performance manage and train primary care physicians… more
- University of Miami (Miami, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Shift: ... UHealth Department of Imaging Services has an exciting opportunity for a Director of Imaging Services in Miami. The incumbent provides strategic leadership,… more
