- Centene Corporation (Tallahassee, FL)
- …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... WEEKENDS AND HOLIDAYS IN THE FUTURE.** **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of service and appropriate… more
- CAI (Tallahassee, FL)
- …Case Manager ready to take us to the next level! If you have prior experience with coordinating, implementing, and evaluating effective treatment and are looking for ... as assigned/requested. **What You'll Need** Required: + Current Registered Nurse , licensed in the state of Delaware + 5...(LBSW) + Licensed Master's Social Worker (LMSW) + Licensed Clinical Social Worker (LCSW) + Experience working with HIV/AIDS… more
- Centene Corporation (Tallahassee, FL)
- …appropriate related to behavioral health (BH) and/or autism spectrum disorder needs and clinical standards + Performs prior authorization reviews related to BH ... state required. Master's degree for behavioral health clinicians required. Behavioral health clinical knowledge and ability to review and/or assess ABA Treatment… more
- Edwards Lifesciences (Tallahassee, FL)
- …event narratives for internal review (eg R&D, quality, RA) or external review ( Clinical Endpoints Committee), as well as for regulatory submissions. + ... complaint information. + Collaborate with senior safety management to review and analyze aggregate safety reports to identify early...clinical and relevant industry experience Required Or + Nurse Practitioner (NP) with a Master's of Science in… more
- Elevance Health (Tallahassee, FL)
- …Provider Finder and follows up with provider on referrals given. + Refers cases requiring clinical review to a nurse reviewer; and handles referrals for ... benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests. + Obtains intake… more
- Merck (Tallahassee, FL)
- …of those options on patients. + Understand the significance and use of clinical trials in multiple tumor types/therapies, both in impact on promoted products and ... (Oncology group purchasing organizations, wholesalers, and specialty pharmacies). + Review and evaluate patterns for products purchased and prescribed (outpatient… more
- Merck (Tallahassee, FL)
- …impact of those options on the patient. Must understand impact and use of clinical trials in multiple tumor types/ therapies, both in impact on promoted products and ... channels of drug distribution, Oncology GPO's, wholesalers and specialty pharmacies. Review and evaluate patterns for products purchased and prescribed, outpatient… more
- Merck (Tallahassee, FL)
- …of those options on patients. + Understand the significance and use of clinical trials in multiple tumor types/therapies, both in impact on promoted products and ... (Oncology group purchasing organizations, wholesalers, and specialty pharmacies). + Review and evaluate patterns for products purchased and prescribed (outpatient… more
- HCA Healthcare (Tallahassee, FL)
- …patient centered care model. In this role you will be required to make clinical assessments of situations and manage treatment autonomously. You would be part of a ... throughout their stay.** **Requirements:** + **Licensed as a Registered Nurse in the State of Florida or able to...the State of Florida or able to obtain licensure prior to start is required** + **1 year of… more
- HCA Healthcare (Tallahassee, FL)
- …patient centered care model. In this role you will be required to make clinical assessments of situations and manage treatment autonomously. You would be part of a ... throughout their stay. **Requirements:** + Licensed as a Registered Nurse in the State of Florida or able to...the State of Florida or able to obtain licensure prior to start is required + 1 year of… more