- Community Based Care of Brevard, Inc. (Orlando, FL)
- Salary: $65,000/year Position Summary: The UM Program Manager provides oversight and management of service authorization data validation, reporting and trend ... line-by-line entries, and submits to finance for payment. The UM Program Manager reconciles ARGOS Dependency Cases...application for daily entry of case activity and the utilization management of service authorizations. Educational and… more
- Molina Healthcare (Orlando, FL)
- …utilization and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies ... adjustment, disease management , and evidence-based guidelines. + Experience in Utilization /Quality Program management + HMO/Managed care experience… more
- AdventHealth (Orlando, FL)
- …Utilization Management . Serves as an active participating member of the Utilization Management ( UM ) Committee by ensuring committee is actively ... this role educates, informs, and advises members of the Utilization Management , Health Information Management ...succeed** **:** + Graduate from medical school and residency program + 5 Recent clinical practice Required + MD… more
- Molina Healthcare (Orlando, FL)
- …necessity of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes ... care at the most effective setting. *Evaluates effectiveness of utilization management ( UM ) practices -...to learn new programs. Preferred Qualifications * Experience with utilization /quality program management . * Managed… more
- Molina Healthcare (Orlando, FL)
- …utilization and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies ... adjustment, disease management , and evidence-based guidelines. + Experience in Utilization /Quality Program management + HMO/Managed care experience… more
- AdventHealth (Orlando, FL)
- …and serves as a resource to Medical Staff colleagues regarding best practices, Utilization Management and Care Management structures, and functions and ... Days Off from Day One + Student Loan Repayment Program + Career Development + Whole Person Wellbeing Resources...productive internal/external relationships with all physicians and constituents of Utilization Management , Care Management and… more
- Molina Healthcare (Orlando, FL)
- …experience as a Medical Director in clinical practice * 3 years' experience in Utilization /Quality Program Management * 2+ years HMO/Managed Care experience ... **Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental… more
- Molina Healthcare (Orlando, FL)
- …with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. Required Qualifications * ... care unit (ICU) or emergency room. Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual /… more
- Molina Healthcare (Orlando, FL)
- …with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. Required Qualifications * ... a medical unit or emergency room. Previous experience in ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG… more
- Molina Healthcare (Orlando, FL)
- …with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. Required Qualifications * ... care. We are seeking a candidate with a RN licensure that has previous UM and Inpatient Hospital experience. Candidates with MCO experience are highly preferred. The… more
- Molina Healthcare (Mid Florida, FL)
- …with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. Required Qualifications * ... and verbal communication skills. * Microsoft Office suite/applicable software program (s) proficiency. Preferred Qualifications * Certified Professional in Healthcare… more
- Molina Healthcare (Orlando, FL)
- …with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. Required Qualifications * ... and verbal communication skills. * Microsoft Office suite/applicable software program (s) proficiency. Preferred Qualifications * Certified Professional in Healthcare… more