- PharmaCord (Orlando, FL)
- …experience with relevant disease state experience preferred. Nurseline triage, Call Center Utilization Management , Call Center Case Management , a plus. ... include: Enable patients by providing them with information and education about: their prescribed therapy and course of treatment,...Case management or Clinical Trial Nurse experience, a plus. Bachelor's degree preferred. We are… more
- CVS Health (FL)
- …anywhere in the state of Florida. **Applicant must reside in Florida** . As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and...setting required - Must have active current and unrestricted RN licensure in state of Florida - Willingness to… more
- AdventHealth (Daytona Beach, FL)
- …**The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse ( RN ) is to use clinical expertise by analyzing patient ... avoidance strategies including concurrent payer communications to resolve status disputes. The Utilization Management Nurse is accountable for a designated… more
- AdventHealth (Tampa, FL)
- …**le you'll contribute:** The role of the Emergency Department Utilization Management (UM) Registered Nurse ( RN ) is to use clinical expertise ... days a week including weekends, holidays and overnight. The Emergency Department UM RN leverages...review as determined by department standards. The Utilization Management Nurse is accountable… more
- Humana (Tallahassee, FL)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse ( RN ) in a… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- CVS Health (Tallahassee, FL)
- … solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team. ... a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM...are not permitted. **Required Qualifications** + Active unrestricted state Registered Nurse licensure in state of residence… more
- Molina Healthcare (St. Petersburg, FL)
- …state board licensing mandate. + At least 2 years in case, disease or utilization management ; managed care; or medical/behavioral health settings. + One year of ... or Clinical Social Worker/Counseling License. + Certified Case Manager (CCM), Utilization Management Certification (CPHM), Certified Professional in Health Care… more
- ERP International (Macdill AFB, FL)
- **Overview** ERP International is seeking a ** Registered ** ** Nurse ( RN )** for a Full-Time position in ** Utilization Management ** at MacDill AFB, FL. ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
- Actalent (Sunrise, FL)
- …Health Utilization Review NurseJob Description We are seeking a dedicated Utilization Management Nurse (UMN) who will work collaboratively with ... an interdisciplinary team under the supervision of the Director and/or Manager/Supervisor of Medical Management . The... department activities as assigned. Essential Skills + Utilization management + Behavioral Health + Mental… more
- Actalent (Sunrise, FL)
- Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing requests ... use of services. Under the general supervision of the Director and/or Manager/Supervisor of Medical Management , and... activities as assigned. Essential Skills + Experience in utilization management , behavioral health, and mental health.… more
- Veterans Affairs, Veterans Health Administration (Tampa, FL)
- …Health Care System is seeking an experienced, dynamic and talented Registered Nurse for Quality/ Utilization Management . Our ideal applicants are those ... and level within the online assessment: https://apply.usastaffing.gov/ViewQuestionnaire/12813233. Grade/Level Scope Education Nurse I, Level I Delivers fundamental,… more
- AdventHealth (Orlando, 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 masters degree or MSN + Prior Care Management / Utilization Management experience +… more
- AdventHealth (Palm Coast, FL)
- …and experiences you'll need to succeed:** **Minimum qualifications** : + Associate's degree Nursing or RN Diploma degree. + Registered Nurse ( RN ) State ... to timely and efficient care delivery and reimbursement. The RN Care Manager provides education to nurses,...+ Health-related Master's degree or MSN. + Prior Care Management / Utilization Management experience. + ACM/CCM… more
- AdventHealth (Palm Coast, FL)
- …and experiences you'll need to succeed:** **Minimum qualifications** : + Associates Degree Nursing or RN Diploma degree + Registered Nurse ( RN ) + Two ... to timely and efficient care delivery and reimbursement. The RN Care Manager provides education to nurses,...+ Health-related Master's degree or MSN + Prior Care Management / Utilization Management experience + ACM/CCM… more
- Mayo Clinic (Jacksonville, FL)
- …patient satisfaction outcomes. The RN Case Manager provides leadership through education on case management / utilization management concepts, ... Competitive retirement package to secure your future. **Responsibilities** The Registered Nurse ( RN ) Case Manager... utilization management , care coordination, resource utilization , and clinical documentation. The RN Case… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …responsible for the strategic direction, leadership, and oversight of all medical management functions, including Utilization Management , and Quality ... with regulatory and accreditation requirements. This position is responsible for the day-to-day management of the Medical Management Department staff, based… more
- CVS Health (FL)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year...or Specialty Pharmacy. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator… more
- HCA Healthcare (West Palm Beach, FL)
- …intrinsic worth of each individual is recognized. Submit your application for the opportunity below: Registered Nurse RN Case Mgr PRN HCA Florida JFK North ... benefits may vary by location._** We are seeking a(an) Registered Nurse RN Case Mgr...Rehab patient. The CM collaborates with the Rehab Program Director and Facility Case Management Director… more
- Community Health Systems (Naples, FL)
- …problem-solving skills for addressing unit challenges and emergencies. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or ... supplies are available and properly utilized while maintaining cost-effective resource management . + Facilitates ongoing education and professional development… more
