• Nurse Utilization Management

    Elevance Health (Tampa, FL)
    Senior RN Utilization Review/ Management (Acute InPatient) JR116937 **Location:** Must be within 50 miles / 1 hour commute of Tampa or Miami, FL offices. This ... Friday. **2 Holidays** per year and **occasional** weekends. The ** Nurse Medical Management Sr** serves as **team...Requires minimum of 5 years acute care clinical experience, utilization management or managed care experience; or… more
    Elevance Health (09/11/24)
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  • Medicare Behavioral Health Outpatient…

    CVS Health (Tallahassee, FL)
    …service like Targeted Care Management , Psychosocial Rehabilitation, or related utilization management experience with these services . Must have active ... residence (LMSW, LCSW, LISW, LPC, or comparable) OR active and unrestricted Registered Nurse licensure with psychiatric specialty/certification in state of… more
    CVS Health (08/23/24)
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  • Utilization Review Clinician

    Monte Nido (Miami, FL)
    …Medicare medical necessity criteria; consult with Admissions staff and Director of Utilization Management on all evaluations for Medicare members including level ... providing the opportunity for people to realize their healthy selves. ** Utilization Review Clinician** **Monte Nido** **Remote** **Monte Nido has been delivering… more
    Monte Nido (09/15/24)
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  • Senior Manager Utilization

    AdventHealth (Altamonte Springs, FL)
    …will provide support, training and guidance to the RN on care management duties/assignments. The Senior Manager of Utilization will be responsible for ... Utilization will oversee ED, Inpatient, and Specialist utilization , and manage care management outcomes. The...degree in nursing with 4 years of experience. . Registered Nurse with an active and unrestricted… more
    AdventHealth (09/06/24)
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  • Registered Nurse RN Care…

    AdventHealth (Maitland, FL)
    …Bachelor's degree in Nursing Degree (or advanced degree) + Experience in Case Management , Utilization Management , Transitional Care + Experience with ... Care Manager System Educator Lead (CMEL) is a care management professional who supports the Director of System Care...+ Three (3) years functional healthcare setting + If RN , Current and valid Florida or Multi-State Department of… more
    AdventHealth (08/16/24)
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  • Registered Nurse RN Care…

    AdventHealth (Apopka, FL)
    …documents avoidable days, and facilitates progression of care. Collaborates with Utilization Management staff for collaboration on patient status changes ... valid State of Florida or multistate license as a Registered Nurse + 2 years of medical/...+ Health-related master's degree or MSN + Prior Care Management / Utilization Management experience +… more
    AdventHealth (09/21/24)
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  • Registered Nurse RN Care…

    AdventHealth (Celebration, FL)
    …documents avoidable days, and facilitates progression of care. Collaborates with Utilization Management staff for collaboration on patient status changes ... valid State of Florida or multistate license as a Registered Nurse + 2 years of medical/...+ Health-related master's degree or MSN + Prior Care Management / Utilization Management experience +… more
    AdventHealth (09/11/24)
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  • Registered Nurse RN Care…

    AdventHealth (Winter Garden, FL)
    …documents avoidable days, and facilitates progression of care. + Collaborates with Utilization Management staff for collaboration on patient status changes and ... satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily...Nursing (BSN) + ACM/CCM Certification + Experience in Care Management / Utilization Management This facility… more
    AdventHealth (08/16/24)
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  • QA/PI Registered Nurse Coordinator…

    AdventHealth (Orlando, FL)
    …include but are not limited to performance of medical record review, utilization management , patient safety, compliance program, orientation program, ongoing ... use of comparative data, performance of specified audits and utilization management activities. + Serves as a...+ Associate's Degree and 3 years of experience + Registered Nurse License + Minimum 3 years… more
    AdventHealth (09/06/24)
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  • Registered Nurse RN

    AdventHealth (Altamonte Springs, FL)
    …experience *Experience in Case Management , Managed Care, Discharge Planning and Utilization Management *Case Management training *Specific knowledge and ... Scope and Standard for Nursing Practice, and the AONE Nurse Executive Competencies. *Liaises between Care Management ,...REQUIRED:** * Basic Life Support - CPR Cert * Registered Nurse This facility is an equal… more
    AdventHealth (09/06/24)
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  • RN Case Manager - Case Management

    Mayo Clinic (Jacksonville, FL)
    …and inclusion, and provides the resources you need to succeed. **Responsibilities** The Registered Nurse ( RN ) Case Manager works within an interdisciplinary ... utilization management , care coordination, resource utilization , and clinical documentation. The RN Case...Graduate of a Nursing program. All entry-level associate degree registered nurses with a RN start date… more
    Mayo Clinic (09/19/24)
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  • RN Case Manager - Case Management

    Mayo Clinic (Jacksonville, FL)
    …and inclusion, and provides the resources you need to succeed. **Responsibilities** The Registered Nurse ( RN ) Case Manager works within an interdisciplinary ... by ensuring appropriate utilization management , care coordination, resource utilization , and clinical documentation. The RN Case Manager will function… more
    Mayo Clinic (09/04/24)
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  • Registered Nurse RN Care…

    AdventHealth (Orlando, FL)
    …+ Associate of Science degree in Nursing (ASN) + Current valid license as a Registered Nurse in the state of Florida + Two (2) years of medical/hospital ... satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily...+ Health-related Master's degree or MSN + Prior Care Management / Utilization Management experience + ACM/CCM… more
    AdventHealth (07/26/24)
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  • Case Manager Registered Nurse - Full…

    University of Miami (Miami, FL)
    …of Case Management . + Incorporates the fundamental principles of utilization management , monitoring resource consumption, social services intervention and ... University of Miami/UHealth has an exciting opportunity for an RN Case Manager in the Case Management ...and community services to patients and families through effective utilization of available resources. + Manages the observation patients… more
    University of Miami (08/30/24)
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  • Director Care Management

    AdventHealth (Orlando, FL)
    …experience in Care Management /Social Work leadership EDUCATION AND EXPERIENCE PREFERRED: Registered Nurse : MSN Social Worker: MSW with LCSW 5-7 years in ... RN license if a nurse LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED: RN -BC Certification in Care Management This facility is an equal opportunity… more
    AdventHealth (09/05/24)
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  • Registered Nurse - Case Manager…

    ERP International (Tyndall AFB, FL)
    **Overview** ERP International is seeking a full time ** Registered Nurse ( RN ) Case Manager** in support of the Wounded Warrior program at the 325th Medical ... algorithms, CM software, and databases for community resources. + Integrate CM and utilization management (UM) and integrating nursing case management with… more
    ERP International (09/11/24)
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  • Interim Director of Case Management

    HealthTrust Workforce Solutions (Bradenton, FL)
    …access to more than 200,000 jobs nationwide. **_JOB SUMMARY_** The Interim Leader of Case Management Services is a Registered Nurse who participates as an ... budget and resource management , cost control, contract compliance, quality improvement, utilization management , denials management and management of… more
    HealthTrust Workforce Solutions (09/13/24)
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  • Registered Nurse RN

    AdventHealth (Altamonte Springs, FL)
    …in direct Care Management State specific RN license if a nurse **Preferred qualifications:** Registered Nurse : BSN Social Worker: MSW Three (3) ... and experiences you'll need to succeed:** **Minimum qualifications** : Registered Nurse : Associates Degree Nursing OR Social...years of experience in direct Care Management CCM, ACM, or RN -BC… more
    AdventHealth (09/05/24)
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  • Registered Nurse ( RN )…

    Health First (Viera, FL)
    …**Job:** ** Registered Nurse * **Organization:** **Viera Hospital Inc* **Title:** * Registered Nurse ( RN ) - Wound Ostomy Continence* **Location:** ... initiative by responding to call lights and bed exit alarms. *QUALIFICATIONS REQUIRED:* * Registered Nurse with current Florida license * Must hold current AHA… more
    Health First (09/01/24)
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  • Registered Nurse Case Manager

    AdventHealth (Land O' Lakes, FL)
    RN . Two (2) years of hospital nursing experience . Current license of registered nurse in Florida or licensure from another state with verification of ... Vapotherm Center of Excellence . Staff consists of all Registered Respiratory Therapist, 65% BSN or above RN...group of patients. The Case Manager is responsible for utilization reviews and resource management , discharge planning,… more
    AdventHealth (08/30/24)
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