- 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 ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied… more
- CenterWell (Tallahassee, FL)
- …caring community and help us put health first** The Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence ... prevent and detect fraud, waste, and abuse. The Compliance Nurse 2 work assignments are varied and...experience a plus + Previous experience in chronic disease management , utilization management , case … more
- Wellpath (Fort Lauderdale, FL)
- …for training, education, and point of care support. **How you make a difference** The Utilization Management Registered Nurse works under the guidance of the ... Experience + Two ( 2 ) years' clinical experience with Utilization Management experience + Previous correctional/detention facility experience… more
- CVS Health (Tallahassee, FL)
- …Must have active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include ... required in med surg or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing in EST or CST… more
- Molina Healthcare (Jacksonville, FL)
- …state they reside. We are looking for a RN Manager to manage a utilization management team supporting 14 Marketplace plans. Home office with internet ... cover any weekend time if needed Preferred candidate with Utilization Management and leadership experience (Direct Reports)..., case management , care transition and/or disease management . + Minimum 2 years of healthcare… more
- Centene Corporation (Tallahassee, FL)
- …28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive ... Analyzes BH member data to improve quality and appropriate utilization of services + Provides education to providers members...of an Accredited School Nursing or Bachelor's degree and 2 - 4 years of related experience. License to… more
- ChenMed (Lakeland, FL)
- …We're rapidly expanding and we need great people to join our team. The Nurse Case Manager 2 (RN) is responsible for achieving positive patient outcomes ... post-acute facilities, as well as their home environments. The Nurse Case Manager 2 (RN) will also...experience required. + A minimum of 1 year of utilization review and/or case management , home health,… more
- Actalent (Tampa, FL)
- …Nursing Facility). + 3 years of concurrent review experience and/or discharge planning. + 2 years of utilization review/ management experience. + 1 year of ... thinking skills under minimal supervision. + Commitment to quality and standards. + Utilization management experience. + Case management experience. +… more
- MyFlorida (Marianna, FL)
- REGISTERED NURSE SPECIALIST - 67039438 (SUNLAND NURSING - ALL SHIFTS) Date: Feb 13, 2025 The State Personnel System is an E-Verify employer. For more information ... Agency: Agency for Persons with Disabilities Working Title: REGISTERED NURSE SPECIALIST - 67039438 (SUNLAND NURSING - ALL SHIFTS)...dynamics. This position with APD will serve staff and management across the Agency. Your work will impact the… more
- MyFlorida (Land O' Lakes, FL)
- SENIOR LICENSED PRACTICAL NURSE - 50000082 Date: Apr 25, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... 843801 Agency: Veterans Affairs Working Title: SENIOR LICENSED PRACTICAL NURSE - 50000082 Pay Plan: Career Service Position Number:...Lakes, Pasco County Annual Salary: $49,960.77 Paid Bi-weekly $1,921.57 2 :45 pm - 11:15 pm & 10:45 pm -… more
- MyFlorida (Orlando, FL)
- 68064646 - REGISTERED NURSE SPECIALIST Date: May 9, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... Agency for Health Care Administration Working Title: 68064646 - REGISTERED NURSE SPECIALIST Pay Plan: Career Service Position Number: 68064646 Salary: $1,915.08… more
- MyFlorida (Chattahoochee, FL)
- REGISTERED NURSE CONSULT-AFTER HOURS - 60005482 Date: May 2 , 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... . Requisition No: 852149 Agency: Children and Families Working Title: REGISTERED NURSE CONSULT-AFTER HOURS - 60005482 Pay Plan: Career Service Position Number:… more
- AdventHealth (Orlando, FL)
- …documents avoidable days, and facilitates progression of care. Collaborates with Utilization Management staff for collaboration on patient status changes ... State of Florida or multistate license as a Registered Nurse + 2 years of medical/ hospital...+ Health-related master's degree or MSN + Prior Care Management / Utilization Management experience +… more
- BayCare Health System (Tampa, FL)
- …to be part of an amazing team and a great place to work!** The ** Nurse Manager** a leader within the health system who demonstrates proficiency in all Quality ... thinking skills when in the clinical setting + Responsible for appropriate utilization of team resources to effectively and efficiently provide clinical services and… more
- ChenMed (Miami, FL)
- …expanding and we need great people to join our team. The Registered Nurse 1, Care Line, is responsible for providing telephonic triage directional patient care ... client counseling, patient advocacy, health education and referral and resource management to ChenMed patients and their families. Providing on-call coverage, the… more
- MyFlorida (Bradenton, FL)
- SENIOR COMMUNITY HEALTH NURSE - 64028532 1 Date: May 2 , 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... No: 850414 Agency: Department of Health Working Title: SENIOR COMMUNITY HEALTH NURSE - 64028532 1 Pay Plan: Career Service Position Number: 64028532 Salary:… more
- ChenMed (Miami, FL)
- …expanding and we need great people to join our team. The Registered Nurse , Telehealth is responsible for providing telephonic triage directional patient care advice ... issues, client counseling, patient advocacy, health education and referral and resource management to ChenMed patients and their families. The incumbent in this role… more
- Elevance Health (Tampa, FL)
- …BS in Nursing preferred. + Proficient in Excel. + Experience in the Utilization Management process strongly preferred. + Clinical skills in hospital-based ... ** Nurse Appeals** **Location** : **Virtual:** This role enables...a HS diploma or equivalent and a minimum of 2 years of experience in a managed care healthcare… more
- Evolent (Tallahassee, FL)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... Be Doing:** + Practices and maintains the principles of utilization management and appeals management ...business need of nurses providing coverage until 7:00pm CST. 2 days/week 8am - 5pm EST/CST - **Required** +… more
- AdventHealth (Daytona Beach, FL)
- …hospital departments including surgery, rehabilitation and occupational therapy, nursing, case management , marketing, home health and others involved in the care of ... included but not limited to 1:1 teaching, preoperative classes, developing and utilization of regional teaching materials and implementing and monitoring the family… more