- Centene Corporation (Tallahassee, FL)
- …Purpose:** Performs reviews of member's care and health status of Applied Behavioral Analysis (ABA) services provided to determine medical appropriateness. ... Evaluates member's care and health status before, during, and after provision of Applied Behavioral Analysis (ABA) services to ensure level of care and services… more
- Centene Corporation (Tallahassee, FL)
- … behavioral health utilization data, KPI review and monitoring of behavioral health utilization management metrics. Participates with development of ... PCP's) and groups identified that are participating in Physical/ Behavioral integration activities. + Works with utilization ,...Physical/ Behavioral integration activities. + Works with utilization , case and disease management teams to… more
- CVS Health (Tallahassee, FL)
- …internal/external clinician support as required including working with the Care Management and Utilization Management teams. **Position Responsibilities:** ... health care more personal, convenient and affordable. **Position Summary:** The Behavioral Health Liaison directs coordination of care between the Aetna **Position… 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
- Humana (Tallahassee, FL)
- … of Pedatric member's (Under 21) who utilize Applied Behavioral Analysis (ABA Services). Monitor/have awareness of utilization , conduct outreaches based on ... help us put health first** The Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses...care and wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work assignments are varied and frequently… 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
- 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)
- …economics, and/or other specific healthcare areas such as EMR, Episode grouper, utilization management , value-based care, low value care etc. **Scheduled Weekly ... Biostatistics, Economics, Statistics, Clinical Informatics, Mathematics, Data Science, Data Analysis and/or related fields + Demonstrated strong analytical thinking… 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