- Elevance Health (Tampa, FL)
- …of Florida. + Requires minimum of 5 years acute care clinical experience, utilization management or managed care experience; or any combination of education ... Senior RN Utilization Review/ Management (Acute InPatient) JR116937 **Location:**...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Tampa, FL)
- ** Utilization Management Representative II** **Location:** Must live within 50 miles of Costa Mesa, CA or a Florida PulsePoint. The ** Utilization ... + Master's degree preferred. Certain contracts require a Master's degree. + Utilization Management experience preferred. + Medical experience preferred, + Long… more
- Elevance Health (Tampa, FL)
- ** Utilization Management Representative II** **Location:** Must live within 50 miles of a Florida PulsePoint. The ** Utilization Management Representative ... benefits and/or eligibility information. + May act as liaison between Medical Management and internal departments. Responds to telephone and written inquiries from… more
- Elevance Health (Tampa, FL)
- …**Preferred skills, Capabilities, and Experience:** + Compact license is preferred. + Utilization Management experience preferred. + Medicaid Utilization ... **Licensed Utilization Review II** **Location** : KS, FL. and...medically appropriate, quality, cost effective care throughout the medical management process. + Educates the member about plan benefits… more
- Elevance Health (Tampa, FL)
- …for people enrolled in Medicaid and/or Medicare programs in Florida. **Licensed Utilization Review Ld** **Location:** This is a remote position. The selected ... based on operational needs (holiday and weekend rotation). The **Licensed Utilization Review Ld** is responsible for collaborating with healthcare providers to… more
- Elevance Health (Tampa, FL)
- **Clinical Operations Associate Medical Director** **Carelon Health** **Genetics Testing Utilization Review** **Location** : The ideal candidate will live within 50 ... proud member of the Elevance Health family of companies, Carelon Medical Benefits Management , formerly AIM Specialty Health, is a benefit- management leader in… more
- AdventHealth (Land O' Lakes, FL)
- …specific group of patients. The Case Manager is responsible for utilization reviews and resource management , discharge planning, treatment plan management ... Service Awards, TWCE as Nice **The role you'll contribute:** The Case Manager is accountable for the organization, sequence of services and resources that… more
- AdventHealth (Zephyrhills, FL)
- …transitions, patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the ... are core competencies of this role. The RN Care Manager facilitates the collaborative management of patient...physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge… more
- ChenMed (St. Petersburg, FL)
- …of care and cost effectiveness through the integrating and functions of case management , utilization review and discharge planning. The incumbent in this role ... need great people to join our team. The Case Manager is responsible for enhancing the quality of patient...nursing discipline) required + A minimum of 7 years' utilization review/case management experience, including psychological aspects… more
- AdventHealth (Tampa, FL)
- …to support a well-balanced work life balance **The role you'll contribute:** The Care Management Manager is under the general leadership of the Care ... daily operations and supervision of team members. The Care Management Manager is responsible for, but not...in related field. . 3 years in direct Care Management / Utilization Management experience in an… more
- Raymond James Financial, Inc. (St. Petersburg, FL)
- …through education and experience in the financial services industry and or risk management to manage multiple projects simultaneously, both large in size and broad ... * Provides a proactive interface for project stakeholders and senior management teams to ensure business requirements are completely and accurately defined.… more
- AdventHealth (Tampa, FL)
- …**Location:** Tampa, FL area **The role you'll contribute:** The Clinical Resource Manager provides leadership and consultation to company facilities in the clinical ... of products and leads multi-disciplinary teams to decrease product variation, utilization and costs through the development of consensus supply utilization… more
- City of Lakeland (Lakeland, FL)
- …City's computer resources and technology development and deployment activities. Generally, the Project Manager I is a project management team member and assists ... corresponding box if you possess any of the following certifications in Project Management . + Project Manager Practitioner + Associate of Project Management… more
- HCA Healthcare (Tampa, FL)
- …where diversity and inclusion thrive? Submit your application for our Performance Improvement Manager Labor opening with HCA Healthcare today and find out what it ... Eligibility for benefits may vary by location._** We are seeking a(an) Performance Improvement Manager Labor for our team to ensure that we continue to provide all… more
- BayCare Health System (New Port Richey, FL)
- … II is responsible for: + In a minimally complex practice, oversees the utilization management and daily business operations of the physician practice at the ... + Responsible for patient access to services, insurance contract verification, utilization management , charge entry, collections, clinical support management… more
- BayCare Health System (St. Petersburg, FL)
- … Manager III** is responsible for: In a complex practice, oversees the utilization management and daily business operations of the physician practice at the ... + Responsible for patient access to services, insurance contract verification, utilization management , charge entry, collections, clinical support management… more
- AdventHealth (Tarpon Springs, FL)
- …care escalations. The Social Worker is under the general supervision of the Care Management Supervisor or Manager and is responsible for patient evaluations of ... transitions, patient satisfaction, patient safety, readmission prevention and length of stay management . The Social Work Care Manager communicates daily with the… more
- AdventHealth (Tampa, FL)
- …care escalations. The Social Worker is under the general supervision of the Care Management Supervisor or Manager and is responsible for patient evaluations of ... transitions, patient satisfaction, patient safety, readmission prevention and length of stay management . The Social Work Care Manager communicates daily with the… more
- SAM LLC (Tampa, FL)
- …and managed throughout their lifecycles. Your Impact at SAM A Geomatics Project Manager is responsible for the oversight and reporting of budgets and utilization ... + 5+ years of industry related work experience in a professional or management capacity + Bachelor's degree in related discipline/and or equivalent experience +… more
- Bristol Myers Squibb (Tampa, FL)
- …to measure the cost-of-service delivery and ongoing administration and vendor utilization . + Lead vendor management activities, contract renewals, ensuring ... more: careers.bms.com/working-with-us . **Position Summary** The Americas Benefits Strategy Delivery Manager (Benefits SDM) is a pivotal role focused on implementing… more