- PharmaCord (Orlando, FL)
- …experience with relevant disease state experience preferred. Nurseline triage, Call Center Utilization Management , Call Center Case Management , a plus. ... persistently despite obstacles and setbacks Requirements: Must have active RN licensure in current state of practice. 2-3 years...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 ... including concurrent payer communications to resolve status disputes. The Utilization Management Nurse is accountable...+ Current and valid license to practice as a Registered Nurse (ADN or BSN) required. +… 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
- AdventHealth (Tampa, FL)
- …contribute:** The role of the Emergency Department Utilization Management (UM) Registered Nurse ( RN ) is to use clinical expertise by analyzing ... for additional review as determined by department standards. The Utilization Management Nurse is accountable...electronic health records of at least two years Preferred RN - Registered Nurse -… 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
- Cognizant (Tallahassee, FL)
- …have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… 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 ... reports on department activities as assigned. Essential Skills + Utilization management + Behavioral Health + Mental...review Additional Skills & Qualifications + Current unrestricted Florida RN or LPN License. + Minimum of one year… more
- Actalent (Sunrise, FL)
- Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing requests ... reports on department activities as assigned. Essential Skills + Experience in utilization management , behavioral health, and mental health. + Proficiency in… 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 ... level degree in Nursing may have opportunity to become registered as a nurse with a state...creditable as related degrees. Preferred Experience: Demonstrated experience in Utilization Management within a healthcare setting, including… 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
- Mayo Clinic (Jacksonville, FL)
- …expenses. + Retirement: Competitive retirement package to secure your future. **Responsibilities** The Registered Nurse ( RN ) Case Manager works within an ... by ensuring appropriate utilization management , care coordination, resource utilization , and clinical documentation. The RN Case Manager will function… more
- Select Medical (Oxford, FL)
- …Illness Recovery Hospital** **Director of Case Management ** **_Clinical license as a registered nurse or respiratory therapist or master's in social work and ... focus on resource management . + Demonstrating compliance with facility-wide Utilization Management policies and procedures. + Coordinating UR compliance with… 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 ... the delivery of high-quality, cost-effective, and patient-centered care. + Oversee Utilization Management to ensure alignment with organizational goals and… 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 ... 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
- 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
- AdventHealth (Palm Coast, FL)
- …and experiences you'll need to succeed:** **Minimum qualifications** : + Associates Degree Nursing or RN Diploma degree + Registered Nurse ( RN ) + Two ... 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
