- Actalent (Sunrise, FL)
- Job Title: Behavioral Health Utilization Review NurseJob Description We are seeking a dedicated Utilization Management Nurse (UMN) who will work ... reports on department activities as assigned. Essential Skills + Utilization management + Behavioral Health ...+ Behavioral Health + Mental Health + Clinical review + Utilization… more
- Actalent (Sunrise, FL)
- Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing ... department activities as assigned. Essential Skills + Experience in utilization management, behavioral health , and...mental health . + Proficiency in clinical and utilization review processes. + Current unrestricted Florida… more
- Molina Healthcare (Miami, FL)
- …dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to ... -related regional medical necessity reviews and cross coverage. * Standardizes behavioral health -related utilization management, quality, and financial… more
- Molina Healthcare (Miami, FL)
- **JOB DESCRIPTION** **Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management ... and chemical dependency services and assists with implementing integrated Behavioral Health care management programs. **Knowledge/Skills/Abilities** Provides… 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. ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG… more
- Elevance Health (Miami, FL)
- …clients/ members. The medical director provides clinical expertise in all aspects of utilization review and case management. Provides input on the clinical ... state or territory of the United States when conducting utilization review or an appeals consideration and...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
- Elevance Health (Miami, FL)
- …Freedom Health , and Optimum Healthcare Plans and will be responsible for utilization review case management for these markets. May be responsible for ... state or territory of the United States when conducting utilization review or an appeals consideration and...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
- HCA Healthcare (Tamarac, 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 ... in developing department goals and clinical programming. + Performs utilization review as assigned. + Helps with...in our Orthopedic and Spine Institute. Our Center for Behavioral Health offers inpatient child, adolescent, adult,… 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 ... law. The **Medical Director-Dermatology Appeals** is responsible for the review of appeals for physical health medical...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
- Molina Healthcare (Miami, FL)
- …Microsoft Office suite/applicable software program(s) proficiency. **Preferred Qualifications** * Utilization management, care management, behavioral health ... to subsequently resolve/correct. **Required Qualifications** * At least 2 years health care experience, preferably in utilization management, care management,… more
- HCA Healthcare (Tamarac, 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 ... on this tradition in our Orthopedic and Spine Institute. Our Center for Behavioral Health offers inpatient child, adolescent, adult, and geriatric services. Our… 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 ... has 417-beds. Our services include trauma, burn, surgical, women's and children's services, behavioral health and diagnostic services. We have two full service… 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 ... has 417-beds. Our services include trauma, burn, surgical, women's and children's services, behavioral health and diagnostic services. We have two full service… 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 ... 2 years of critical care experience + Certification in case management or utilization review preferred + InterQual experience preferred HCA Florida Kendall… more
- Cleveland Clinic (Weston, FL)
- …to ensure compliance and strong performance across safety, quality, utilization and patient experience metrics and support implementation of requirements ... objectives and key results. + Model Cleveland Clinic Core Values and behavioral standards. + Coordinate with cross functional stakeholders to ensure compliance with… 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 ... 2 years of critical care experience + Certification in case management or utilization review preferred + InterQual experience preferred HCA Florida Aventura… 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 ... etc.) hospital nursing experience required + Certification in case management or utilization review preferred + InterQual experience preferred HCA Florida… 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 ... etc.) hospital nursing experience required + Certification in case management or utilization review preferred + InterQual experience preferred HCA Florida Mercy… 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 ... HCA Florida Aventura Hospital offers a total rewards package that supports the health , life, career and retirement of our colleagues. The available plans and… 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...critical care experience + Certification in case management or utilization review preferred + InterQual experience preferred… more