- CVS Health (Tallahassee, FL)
- …**_Must reside in state of Florida, position is 100% remote._** Behavior Analysis Utilization Management Clinical Consultant applies critical thinking ... clinically appropriate treatment, evidence-based care and clinical practice guidelines for Behavioral Health, specific to Behavior Analysis . Utilizes clinical… more
- Centene Corporation (Tallahassee, FL)
- …abuse across the continuum of care. Experience with managed care, case management , utilization management , or quality improvement. **License/Certification:** ... review of member clinical records and services related to behavioral health and substance use. + Interpret and present...member satisfaction + Serve as resource and liaison on utilization , quality improvement and case management activities… more
- MyFlorida (Chattahoochee, FL)
- …for the position: * Knowledge of the theories and principles of behavior analysis . * Knowledge of behavioral functional assessment. * Knowledgeable in the ... subtleties of group dynamics. This position with APD will serve staff and management across the Agency. Your work will impact the workplace culture, our community,… more
- MyFlorida (Tallahassee, FL)
- …operations, human resource management , budgets, facility infrastructure and bed utilization . + Knowledge of data analysis and performance/operation metric. ... apply applicable rules, regulations, policies and procedures relating to operational and management analysis activities. + Ability to organize data into logical… more
- MyFlorida (Tallahassee, FL)
- …apply applicable rules, regulations, policies and procedures relating to operational and management analysis activities. - Ability to organize data into logical ... and evaluation. - Have three years of professional experience with systems and management analysis . - Have three years of professional experience with research… more
- Humana (Tallahassee, FL)
- …**Value Based Program** models for range of provider types, such as behavioral health, maternity, specialists, and social determinants of health, creating glide ... with Medicaid contractual requirements and RFP commitments. + Analyze financial, utilization , and performance data to identify opportunities to drive improvements in… more
- Highmark Health (Tallahassee, FL)
- …delivery models. This is completed via baseline provider performance/practice analysis , gap assessment, team facilitation, transformation plan development, fostering ... business problems that require risk assessment, sound business judgment and change management skills. + Provide solid, actionable recommendations as to what he/she… more
- Centene Corporation (Tallahassee, FL)
- …Interact with network practitioners to provide education on best practice models and utilization management processes + Interact with the Medical Director, or ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
- NASCO (Tallahassee, FL)
- …general supervision, the System Engineer II is responsible for the analysis , construction, testing and implementation of changing business needs (requirements) and ... wide (or Plan Enterprise) implementation of product capabilities related to data management and membership or billing processing subsystems. This role aids Plan… more
- HCA Healthcare (Tallahassee, FL)
- …opportunities, strategic planning, revenue and reimbursement enhancement, cost and utilization management , and improved operational performance. The Assistant ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services...The Division Assistant Controller provides timely information and financial analysis to senior management for the purpose… more
- Humana (Tallahassee, FL)
- …Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable ... Professional's primary role is to develop organized analytics, reports and data management to support the market's Quality team within the Medicaid product line.… more
- Highmark Health (Tallahassee, FL)
- …to deliver financial results to the Enterprise. **ESSENTIAL RESPONSIBILITIES** + Perform management responsibilities to include, but are not limited to: involved in ... termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.Plan, organize, staff, direct and control the… more
- Humana (Tallahassee, FL)
- …payer economics, and/or other specific healthcare areas such as EMR, Episode grouper, utilization management , value-based care, low value care etc. + Experience ... Biostatistics, Economics, Statistics, Clinical Informatics, Mathematics, Data Science, Data Analysis and/or related fields + Experience in the healthcare industry… more
- Highmark Health (Tallahassee, FL)
- …resource efficiency. + Proposes ideas, designs, and solutions to lead engineers and management to further cloud service utilization and optimization. + Develops ... and services into cloud environments. + Performs research and analysis required for new cloud deployment proposals, existing cloud...of action. + Level 3 Incident, problem and change management as it pertains to the responsibilities of the… more