- Healthfirst (FL)
- **Duties/Responsibilities:** + Oversees utilization management functions which include timely authorizations related to pre-certification, concurrent review, ... and reviews medical charts to obtain additional information required for appropriate utilization management and to solve complex clinical problems + Allocate,… more
- Actalent (Sunrise, FL)
- Actalent is hiring UM nurses!Job Description The Utilization Management Nurse (UMN) plays a crucial role in optimizing the utilization of healthcare ... Working under the general supervision of the Director and/or Manager /Supervisor of Medical Management , and in collaboration...on department activities. Essential Skills + Clinical review + Utilization review + Utilization management … more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …safe discharge coverage for all hospital units. + Participates in utilization management initiatives/opportunities for improvement through departmental committee ... the State of Florida. + 3 years minimum experience in discharge planning, utilization management , or case management . + Basic proficiency in Microsoft Word,… more
- Ascension Health (Pensacola, FL)
- …salary range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes ... **Details** + **Department: Utilization Review** + **Schedule: Full time days** +...utilization criteria, appeal and review process, and case management system documentation. + Conduct hiring, training, directing, development… more
- Elevance Health (Tampa, FL)
- ** Utilization Management Representative I** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person ... integration, and ensures essential face-to-face onboarding and skill development. The ** Utilization Management Representative I** will be responsible for… more
- CenterWell (Tallahassee, FL)
- …UM Administration Coordinator - Phone Intake contributes to administration of utilization management . The UM Administration Coordinator performs varied ... service or customer service telephone experience desired + Experience with Utilization Review and/or Prior Authorization, preferably within a managed care… more
- Select Medical (Panama City, FL)
- …by doing what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning, treatment plan management ... **Overview** **Critical Illness Recovery Hospital** **Case Manager (PRN)** _Requires a current licensure in a...the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates… more
- CenterWell (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Manager Care/Case Management in **Palm Beach/TC area** is responsible for managing a ... for managing populations and coordinating care to reduce acute and post-acute care utilization . The Manager role is hybrid with travel requirements to preferred… more
- ChenMed (North Miami Beach, FL)
- …years' clinical work experience required. + A minimum of 1 year of utilization review and/or case management , home health, hospital discharge planning experience ... post-acute facilities, as well as, their home environments. The Nurse Case Manager 1 (RN) role also involves establishing relationships with patients' families and… more
- Grifols Shared Services North America, Inc (Orlando, FL)
- …specified "Account List" of Health Systems designed to increase the adoption and utilization of the Grifols Bleeding Management product portfolio. The KAM's ... countries and regions. **Role and Responsibilities of a Bleeding Management KAM** **About the Role:** The KAM will play...provide any necessary support to the responsible National Account Manager (NAM) in the execution of the contracting process… more
- AssistRx (Orlando, FL)
- …to process improvement initiatives, to pharmacy client implementations. We are looking for an Manager of Project Management to assist the Director of Project ... with updating processes and leading the current project management team. Requirements + Manage and drive implementation methodology...transition to operations + Drive to business outcomes & utilization , not just deadlines + Drives adherence to IT… more
- TD Bank (Fort Lauderdale, FL)
- …of Business:** Human Resources **Job Description:** **Department Overview:** The Senior Manager , Financial Crime Risk Management Training leads/manages a team ... risk awareness across the organization. **Depth & Scope:** + Provides people management leadership by hiring the best talent, setting goals, developing staff,… more
- AdventHealth (Minneola, FL)
- …Social Worker: BSW Masters in related field - Required + 3 years direct Care Management / Utilization Management experience in an acute care setting - Required ... spirit in the Minneola community. **The role you'll contribute:** The Care Management Senior Manager is under the general leadership of the Care Management … more
- University of Miami (Hialeah, FL)
- … to work in the UHealth Medical Campus. Core Job Summary The Asset Management Manager is responsible for managing strategic capital equipment deployment and ... Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Manager , Asset Management The University of Miami/UHealth… more
- HCA Healthcare (Ocala, FL)
- **Description** **Introduction** Do you have the career opportunities as a(an) Manager Case Management you want with your current employer? We have an exciting ... of colleagues. Do you want to work as a(an) Manager Case Management where your passion for...Performs admission certification screening for patients in accordance with Utilization Plan using ISD criteria, and performs concurrent stay… more
- AdventHealth (Altamonte Springs, FL)
- …Altamonte Springs, FL 32714 **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
- AdventHealth (Maitland, FL)
- …documents avoidable days, and facilitates progression of care. Collaborates with Utilization Management staff for collaboration on patient status changes ... is under the general supervision of the Care Management Supervisor or Manager and is responsible...+ Health-related Master's degree or MSN + Prior Care Management / Utilization Management experience + ACM/CCM… more
- HCA Healthcare (Tallahassee, FL)
- …and assess observation patients for appropriateness in observation status + Performs utilization management reviews and communicates information to third party ... to make a real impact. As a(an) RN Case Manager you can be a part of change. **Benefits**...within 30 days of start + Certification in Case Management , Nursing, or Utilization Review, preferred +… more
- HCA Healthcare (Gainesville, FL)
- …experience required. Case management experience preferred. + Certification in Case Management , Nursing or Utilization Review is preferred HCA Florida North ... you have the career opportunities as a(an) RN Case Manager you want in your current role? We invest...Summary and Qualifications** We are seeking a dynamic Case Management RN to join our team. The RN Case… more
- Truist (Orlando, FL)
- …vision and strategic plan of the respective area under Enterprise Fraud Management leadership. Lead, develop and manage personnel and workflow to ensure maximum ... efficiency and utilization of all available resources in accomplishing departmental/corporate objectives...products and channels 7. Minimum 5 years in a management role 8. Proven leadership and team building skills… more