- CVS Health (Tallahassee, FL)
- …**_Must reside in state of Florida, position is 100% remote._** Behavior Analysis Utilization Management Clinical Consultant applies critical thinking ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + Must have active,… more
- CVS Health (Tallahassee, FL)
- …Must have active current and unrestricted RN licensure in state of residence - Utilization management is a 24/7 operation. Work schedules will include weekend, ... required in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in EST or CST zones… more
- Cardinal Health (Tallahassee, FL)
- …1 supporting the Central Region, 1 supporting the Southeast Region.** **_What Clinical Operations contributes to Cardinal Health_** Clinical Operations is ... and service education to facilitate technology adoption and workflow change management . + Demonstrates extensive knowledge and understanding of relevant clinical… more
- Cardinal Health (Tallahassee, FL)
- **_What Specialty Networks contributes to Cardinal Health_** Specialty Networks creates clinical & economic value for independent specialty providers & partners in ... Networks in creating value to the members in their clinical , operational, and economical goals. This individual will be...Member Profiles and overall success of membership network with utilization and optimization of Salesforce keeping up to date… more
- Sedgwick (Tallahassee, FL)
- …assessment, planning, coordination, implementation, and reporting of complex clinical data; to complete complex submissions revisions/updates in preparation ... final determination based on applicable coverage policies, coding guidelines and utilization and practice guidelines. + Reviews medical claims and completes complex… more