- Community Health Systems (Naples, FL)
- …written and verbal communication skills. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact State Licensure Current ... **Job Summary** Under the direction of the UR Director/Manager the UR Nurse reviews all admissions for medical necessity, correct orders based on medical condition… more
- Ascension Health (Pensacola, FL)
- **Details** **Department: Utilization Review ** **Schedule: M-F 0800-1630 with rotating Holidays** **Hospital: Ascension Sacred Heart Pensacola** **Location: ... Provide health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests… 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...in NUMI following VACO UM process and then InterQual review process. Facilitates and coordinates admissions to the most… more
- Humana (Tallahassee, FL)
- …skills to make an impact** **Required Qualifications** + Compact licensure + Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary ... of our caring community and help us put health first** The SNF Utilization Management Nurse uses clinical knowledge, communication skills, and independent… more
- CVS Health (Tallahassee, FL)
- …and 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
- Zurich NA (Tallahassee, FL)
- AVP, Utilization Review & Pharmacy 123092 Zurich Insurance is seeking an AVP, Utilization Review & Pharmacy. This is a fully remote position, offering ... flexibility of a home-based office. As the AVP of Utilization Review & Pharmacy, you will lead...more years of experience in the Nursing areaAND + Registered Professional Nurse license in residential area… more
- Ascension Health (Pensacola, FL)
- **Details** + **Department: Utilization Review ** + **Schedule: Full time days** + **Hospital: Ascension Sacred Heart Pensacola** + **Location: Pensacola, ... salary range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes… more
- Centene Corporation (Tallahassee, FL)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... perspective on workplace flexibility. **Position Purpose:** Performs a clinical review and assesses care related to mental health and...Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact… more
- ChenMed (North Miami Beach, FL)
- …assess and record patients' progress and adjust and plan accordingly. + Understanding utilization review and how to leverage with inpatient staff for possible ... a related clinical field preferred. + A valid, active Registered Nurse (RN) license in State of...experience required. + A minimum of 1 year of utilization review and/or case management, home health,… more
- ChenMed (Lakeland, FL)
- …assess and record patients' progress and adjust and plan accordingly. + Understanding utilization review and how to leverage with inpatient staff for possible ... a related clinical field preferred. + A valid, active Registered Nurse (RN) license in State of...experience required. + A minimum of 1 year of utilization review and/or case management, home health,… more
- MyFlorida (Orlando, FL)
- SENIOR REGISTERED NURSE SUPV Date: May 16, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... Requisition No: 849196 Agency: Veterans Affairs Working Title: SENIOR REGISTERED NURSE SUPV Pay Plan: Career Service...that the residents are receiving total nursing care. + Review shift assignments and ensure that the assignments reflect… more
- MyFlorida (Land O' Lakes, FL)
- SENIOR REGISTERED NURSE SUPV - 50000071 Date: May 14, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... Requisition No: 853135 Agency: Veterans Affairs Working Title: SENIOR REGISTERED NURSE SUPV - 50000071 Pay Plan:...and that the residents are receiving total nursing care. Review shift assignments and ensure that the assignments reflect… more
- MyFlorida (Bunnell, FL)
- SENIOR REGISTERED NURSE - 64068640 Date: Jun 3, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... No: 854377 Agency: Department of Health Working Title: SENIOR REGISTERED NURSE - 64068640 Pay Plan: Career...as delegated by the nursing supervisor. Participates in record review for quality assurance. Assists with outreach clinics for… more
- MyFlorida (Port Saint Lucie, FL)
- SENIOR REGISTERED NURSE SUPV Date: Jun 5, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... Requisition No: 854386 Agency: Veterans Affairs Working Title: SENIOR REGISTERED NURSE SUPV Pay Plan: Career Service...that the residents are receiving total nursing care. + Review shift assignments and ensure that the assignments reflect… more
- Veterans Affairs, Veterans Health Administration (Miami, FL)
- Summary The Miami VA Healthcare System is looking for a Registered Nurse - Community Living Center - Minimum Data Set who will be responsible and accountable for ... policies and guidelines. Responsibilities VA offers a comprehensive total rewards package: VA Nurse Total Rewards The Registered Nurse Community Living… more
- MyFlorida (Daytona Beach, FL)
- REGISTERED NURSE - 50001802 Date: Jun 2, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 854031 Agency: Veterans Affairs Working Title: REGISTERED NURSE - 50001802 Pay Plan: Career...and procedures. + Monitor physician's orders for completion. + Review and follow-up on resident incidents or complaints. +… more
- MyFlorida (Panama City Beach, FL)
- OPS REGISTERED NURSE - 50601527 Date: May 23, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... Requisition No: 843089 Agency: Veterans Affairs Working Title: OPS REGISTERED NURSE - 50601527 Pay Plan: Health...and procedures + Monitor physician's orders for completion + Review and follow-up on resident incidents or complaints +… more
- MyFlorida (Orlando, FL)
- OPS REGISTERED NURSE (WW) Date: May 28, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... Requisition No: 834086 Agency: Veterans Affairs Working Title: OPS REGISTERED NURSE (WW) Pay Plan: Health Care...and procedures. + Monitor physician's orders for completion. + Review and follow-up on resident incidents or complaints. +… more
- ChenMed (Tampa, FL)
- …to join our team. The Community Care team is a multidisciplinary service including Registered Nurse (RN) Community Care nurses, Licensed Practical Nurse ... DUTIES/RESPONSIBILITIES:** + Under the direction and supervision of a Registered Nurse (RN) provides in home and...in Case Management: + A minimum of 2 years' utilization review and/or case management, home health… more
- AdventHealth (Clearwater, FL)
- …care needs in this senior population. AdventHealth Senior Care is looking for a Registered Nurse to be responsible for achieving and leading a high-quality care ... to increase quality, increase patient satisfaction and reduce unnecessary utilization of health care resources. AdventHealth Senior Care is...for the member throughout the health care system. The Registered Nurse serves as an advocate for… more