- 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
- CVS Health (Tallahassee, FL)
- …Aetna state Medicaid plan. This may include substance use disorder (SUDS), Applied Behavioral Analysis (ABA), Trauma Informed Care, Person Centered Services, and ... the plan and works across various departments including Care Management , Utilization Management , Quality ... Management , Quality Management , and Medical Management on issues related to Behavioral Health.… 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 (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
- Highmark Health (Tallahassee, FL)
- …of an Application Portfolio Management (APM) strategy, including lifecycle management , portfolio analysis and optimization + Other duties as assigned ... policy for selection of architecture components. + Evaluate and perform impact analysis on major design options. + Lead and facilitate development of enterprise… 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. + Familiarity ... Biostatistics, Economics, Statistics, Clinical Informatics, Mathematics, Data Science, Data Analysis and/or related fields + Experience working with healthcare data… more
- MyFlorida (Tallahassee, FL)
- …system updates (ie AWARE upgrades, Social Security Application, Rehab Center Management , National Voter Registration App, Federal Reporting, etc.) + Coordinates user ... reports summarizing business, financial and economic data for review by senior management , clients or stakeholders. + Serves as primary resource for the alignment… 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