Top 1826 Remote jobs Jobs in Tampa, Fl

Care Review Clinician (BH Licensed) - Remote in FL
Molina Healthcare, Inc. —Tampa, FL
- $26.41 - $51.49 an hour
- Full-time
- Remote
- LMFT
- Licensed Clinical Social Worker
- Mid-level
- Health insurance
Bioinformatician - AI Trainer
DataAnnotation —Riverview, FL
- $50 - $100 an hour
- Part-time
- Remote
- Computer Science
- English
- Mid-level
- Flexible schedule
Quick Apply
Full Stack Developer - AI Trainer
DataAnnotation —Riverview, FL
- $50 - $100 an hour
- Part-time
- Remote
- Writing skills
- English
- Mid-level
- Flexible schedule
Quick Apply
Accounts Receivable Specialist - AI Trainer
DataAnnotation —Temple Terrace, FL
- $50 - $100 an hour
- Part-time
- Remote
- Mid-level
- Master's degree
- Bachelor's degree
Quick Apply
Data Scientist - AI Trainer
DataAnnotation —Temple Terrace, FL
- $50 - $100 an hour
- Part-time
- Remote
- Writing skills
- English
- Mid-level
- Flexible schedule
Quick Apply
Document Review Clerk
Lincare Pharmacy Services Inc. —Clearwater, FL
- Remote
- Computer literacy
- High school diploma or GED
- Quality control
Quick Apply
Remote Client Agent – Work From Home | Training Provided
The Gainey Agency —Tampa, FL
- Remote
- Sales
- Customer service
- Computer literacy
- Opportunities for advancement
- Flexible schedule
Quick Apply
Remote Customer Service/Sales Representative
Agent Alliance —Tampa, FL
- $65,000 - $70,000 a year
- Full-time
- Remote
- Entry level
- Paid training
- Health insurance
Quick Apply
Client Success Representative (Remote)
Demand.com —Tampa, FL
- Remote
- Mid-level
- Communication skills
- Time management
Quick Apply
Client Service Specialist
UnitedHealth Group —Saint Petersburg, FL
- $20 - $36 an hour
- Overtime
- Remote
- Microsoft Outlook
- Pass drug screening
- Mid-level
Data Analyst - AI Trainer
DataAnnotation —Clearwater, FL
- $50 - $100 an hour
- Part-time
- Remote
- Writing skills
- English
- Mid-level
- Flexible schedule
Quick Apply
Inbound Sales Consultant - FL
Viking Cruises US —Florida
- $80,000 - $190,000 a year
- Weekends as needed
- Remote
- Microsoft Outlook
- 5 years
- Senior level
- Paid training
- Employee stock purchase plan
Quick Apply
Remote Seasonal Health Insurance Sales and Enrollment Agent
Qualfon —Florida
- From $25 an hour
- Full-time
- Remote
- 18 years or older
- Mid-level
- High school diploma or GED
- Disability insurance
- Health insurance
9d
Mortgage Loan Officer - FL Residents Only
Approved Mortgage —Tampa, FL
- $50,000 - $500,000 a year
- Part-time
- Remote
- Microsoft Word
- Background check
- Microsoft Excel
- Health insurance
- Dental insurance
Inpatient Coding Specialist, Fully Remote, $5000 Bonus,CCS or RHIT certified
Baptist Health South Florida —Florida
- $29.41 - $38.23 an hour
- Remote
- Microsoft Word
- Mid-level
- High school diploma or GED
- Wellness program
- Continuing education credits
Customer Service Representative
WOODIES WASH SHACK —Tampa, FL
- From $18 an hour
- Weekends as needed
- Remote
- Background check
- 18 years or older
- Travel
- Health insurance
- Dental insurance
Quick Apply
Clinical Administrative Coordinator
UnitedHealthcare —Tampa, FL
- $18 - $32 an hour
- 8 hour shift
- Remote
- 18 years or older
- Microsoft Outlook
- Pass drug screening
- AD&D insurance
- Employee stock purchase plan
Admissions Representative
UMA Education —Tampa, FL
- $20 an hour
- Weekends as needed
- Remote
- 18 years or older
- High school diploma or GED
- Travel
- Paid training
- Health savings account
Quick Apply
Enrollment Administrator - Customer Support for Learning and Development
Lifted, an Upwork Company™ —Tampa, FL
- Overtime
- Remote
- Background check
- School experience
- Microsoft Excel
- Work from home
Quick Apply
Customer Service and Tech Support - Customer Support for Learning and Development
Lifted, an Upwork Company™ —Tampa, FL
- Contract
- Remote
- Background check
- School experience
- Microsoft Excel
- Work from home
Quick Apply

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Care Review Clinician (BH Licensed) - Remote in FL

Molina Healthcare, Inc. -
Tampa, FL

Apply Now

Job Details

Full-time
$26.41 - $51.49 an hour

Benefits

Health insurance

Qualifications

Productivity software

Full Job Description

JOB DESCRIPTION Job Summary

Provides support for member clinical service review processes specific to behavioral health. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations, and ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

Assesses services for members - ensuring optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines.
Analyzes clinical service requests from members or providers against evidence based clinical guidelines.
Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures.
Conducts reviews to determine prior authorization / financial responsibility for Molina and its members.
Processes requests within required timelines.
Refers appropriate cases to medical directors and presents cases in a consistent and efficient manner.
Requests additional information from members or providers as needed.
Makes appropriate referrals to other clinical programs.
Collaborates with multidisciplinary teams to promote Molina care model.
Adheres to utilization management (UM) policies and procedures.
May work collaboratively with appropriate departments to provide applied behavior analysis (ABA)/behavioral health therapy (BHT) services to Molina members with autism spectrum disorder (ASD) and other related disorders.
May approve requests for BHT by reviewing behavioral assessments and treatment plans for medical necessity and BHT best practice guidelines. This includes but is not limited to: psychological evaluation requests, comprehensive diagnostic evaluations, functional behavioral assessments, and progress reports.
May perform ongoing monitoring of BHT treatment plans to evaluate effectiveness and treatment efficacy.
May provide peer to peer consultation BHT in-network providers to support treatment planning and maximize member progress.
May work collaboratively with ABA providers to ensure best service practices for members.
May create and develops forms, recommendations and guidelines and training for BHT service delivery.
May collaborate and coordinate with behavioral health medical directors, and senior medical directors to ensure proper management of the BHT benefit.

Required Qualifications

At least 2 years health care experience, including experience in behavioral health and/or hospital acute care, or equivalent combination of relevant education and experience.
Licensed Clinical Social Worker (LCSW), Licensed Master Social Worker (LMSW), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC), Licensed Marriage and Family Therapist (LMFT) or equivalent behavioral health licensure. License must be active and unrestricted in state of practice.
May require behavioral analyst experience, and/or board certification/licensure as a behavioral analyst (BCBA and/or LBA).
Demonstrated knowledge of community resources.
Ability to operate proactively and demonstrate detail-oriented work.
Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
Ability to work independently, with minimal supervision and demonstrate self-motivation.
Responsive in all forms of communication, and ability to remain calm in high-pressure situations.
Ability to develop and maintain professional relationships.
Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
Excellent problem-solving, and critical-thinking skills.
Strong verbal and written communication skills.
Microsoft Office suite/applicable software program(s) proficiency.

Preferred Qualifications

Recent hospital behavioral health experience in an intensive care unit (ICU) or emergency room.

#PJHS3

#LI-AC1

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Apply Now

Refine Your Search

remote jobs jobs in tampa, fl

Care Review Clinician (BH Licensed) - Remote in FL

Bioinformatician - AI Trainer

Full Stack Developer - AI Trainer

Accounts Receivable Specialist - AI Trainer

Data Scientist - AI Trainer

Document Review Clerk

Remote Client Agent – Work From Home | Training Provided

Remote Customer Service/Sales Representative

Client Success Representative (Remote)

Client Service Specialist

Data Analyst - AI Trainer

Inbound Sales Consultant - FL

Remote Seasonal Health Insurance Sales and Enrollment Agent

Mortgage Loan Officer - FL Residents Only

Inpatient Coding Specialist, Fully Remote, $5000 Bonus,CCS or RHIT certified

Customer Service Representative

Clinical Administrative Coordinator

Admissions Representative

Enrollment Administrator - Customer Support for Learning and Development

Customer Service and Tech Support - Customer Support for Learning and Development

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