- Humana (Tallahassee, FL)
- …and programs **Use your skills to make an impact** **Required Qualifications** + Registered nurse ( RN ) with unrestricted licensed **OR** independent licensed ... of our caring community and help us put health first** The Utilization Management (UM) Director, Clinical Strategy and Practice for Medicaid builds strategies… more
- CVS Health (Tallahassee, FL)
- …active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include weekends, ... **Required Qualifications** + 2+ years of experience as a Registered Nurse in adult acute care/critical care...or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing… more
- AdventHealth (Orlando, FL)
- …**The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse ( RN ) is to use clinical expertise by analyzing patient ... and valid license to practice in Florida as a Registered Nurse (ADN or BSN) required. +...care clinical nursing experience required. + Minimum two years Utilization Management experience, or equivalent professional experience.… more
- Humana (Tallahassee, FL)
- …part of our caring community and help us put health first** The SNF Utilization Management Nurse uses clinical knowledge, communication skills, and ... where needed. Follows established guidelines and procedures. The SNF Utilization Management Nurse uses clinical...an impact** **Required Qualifications** + Compact licensure + Licensed Registered Nurse ( RN ) in the… more
- CVS Health (Tallahassee, FL)
- …administration of the utilization /benefit management function. Required Qualifications + Registered Nurse in state of residence. + 3+ years of Nursing ... experience. Preferred Qualifications + Prior authorization utilization management /review experience preferred Outpatient Clinical experience. + Knowledge of… more
- Veterans Affairs, Veterans Health Administration (Gainesville, FL)
- Summary The Utilization Management (UM) Registered Nurse ( RN ) is responsible for UM reviews for patients who receive hospital care. Responsibilities ... An UM Registered Nurse is responsible for UM reviews...accreditation standards, and performance measures. Uses emergency and bed management software and utilization data to manage… more
- Ascension Health (Pensacola, FL)
- …and coordinate compliance to federally mandated and third party payer utilization management rules and regulations. **Requirements** Licensure / Certification ... offer._ **Responsibilities** Provide health care services regarding admissions, case management , discharge planning and utilization review. +.../ Registration: + Licensed Registered Nurse credentialed from the Florida Board… 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 ... assignments. Qualifications: + Registered Nurse or Licensed Practical Nurse...Florida. + 3 years minimum experience in discharge planning, utilization management , or case management .… more
- Ascension Health (Pensacola, FL)
- …evaluation of staff. **Requirements** Licensure / Certification / Registration: + Licensed Registered Nurse credentialed from the Florida Department of Health ... salary range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes… more
- AdventHealth (Altamonte Springs, 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
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …and goals. + Clearly and succinctly documents necessary and/or required information in Utilization Management system. + Monitors and complies with all state, ... subject matter expertise, as well as knowledge of the interconnection between Utilization Management , claims, and regulatory requirements to respond to complex… 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
- HCA Healthcare (Port St. Lucie, FL)
- **Description** **Introduction** Do you have the career opportunities as a(an) Registered Nurse RN Case Mgr you want with your current employer? We have an ... of colleagues. Do you want to work as a(an) Registered Nurse RN Case Mgr...etc.) hospital nursing experience required + Certification in case management or utilization review preferred + InterQual… more
- ERP International (Eglin AFB, FL)
- **Overview** ERP International is seeking a ** Registered Nurse ( RN )** for a full-time **Case Manager** position in support of the **Eglin Hospital, Eglin ... and databases for community resources. + Integrate CM and utilization management (UM) and integrating nursing case...license from any US State. Clinical Certification:** Desired Case Management certification, ie ACCC, CRC, RN -NMC, CMC… more
- ChenMed (North Miami Beach, FL)
- …RN with bachelor's degree in a related clinical field preferred. + A valid, active Registered Nurse ( RN ) license in State of employment required. + A ... great people to join our team. The Acute Care Nurse ( RN ) is responsible for achieving positive...experience required. + A minimum of 1 year of utilization review and/or case management , home health,… more
- AdventHealth (Winter Park, FL)
- …experience *Experience in Case Management , Managed Care, Discharge Planning and Utilization Management *Case Management training *Specific knowledge and ... by the unit of work (see competencies) **LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:** * Registered Nurse Current valid Florida State Licensure as a RN… more
- ChenMed (Lakeland, FL)
- …RN with bachelor's degree in a related clinical field preferred. + A valid, active Registered Nurse ( RN ) license in State of employment required. + A ... we need great people to join our team. The Nurse Case Manager 2 ( RN ) is responsible...experience required. + A minimum of 1 year of utilization review and/or case management , home health,… more
- HCA Healthcare (Fort Pierce, FL)
- …ICU, CVICU etc.) hospital nursing experience required + Certification in case management or utilization review preferred + InterQual experience preferred HCA ... colleagues invested over 156,000 hours volunteering in our communities. As a(an) Case Mgr RN with HCA Florida Lawnwood Hospital you can be a part of an organization… more
- MTC (Quincy, FL)
- …record or other forms as appropriate. + Practice basic cost containment and utilization management for inmate care and facility operations. + Maintain absolute ... in one package!** Are you a dedicated and skilled RN looking for a meaningful opportunity to provide exceptional...with an acceptable driving record required, unless waived by management . Management & Training Corporation (MTC) is… 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 ... on department activities. Essential Skills + Clinical review + Utilization review + Utilization management ... Additional Skills & Qualifications + Current unrestricted Florida RN or LPN License + Minimum of two years… more