- Veterans Affairs, Veterans Health Administration (Miami, FL)
- Summary The Miami VA medical Center is looking for recruit for Registered Nurse - Utilization Management / Float who is responsible and accountable for ... a comprehensive total rewards package: VA Nurse Total Rewards The Utilization Management /Float Registered Nurse is located at the Nursing,… more
- ChenMed (Miami, FL)
- …We're rapidly expanding and we need great people to join our team. The Registered Nurse , Care Line, is responsible for providing telephonic triage directional ... and assessments within license and as possible given technology and medium. The registered nurse collaborates with primary caregivers and others on the… more
- HCA Healthcare (Davie, FL)
- …Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a(an) Registered Nurse Case Mgr with HCA Florida University Hospital you ... in our organization. We are looking for an enthusiastic Registered Nurse Case Mgr to help us...years of critical care experience + Certification in case management or utilization review preferred + InterQual… more
- HCA Healthcare (Tamarac, FL)
- …**Introduction** Do you want to join an organization that invests in you as a(an) Registered Nurse RN Case Mgr PRN? At HCA Florida Woodmont Hospital, you come ... make a difference. We are looking for a dedicated Registered Nurse RN Case Mgr PRN like...2 years of critical care experience Certification in case management or utilization review preferred + InterQual… more
- HCA Healthcare (Margate, 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 where your...years of critical care experience + Certification in case management or utilization review preferred + InterQual… more
- HCA Healthcare (Aventura, FL)
- …Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a(an) Registered Nurse Case Mgr RN PRN with HCA Florida Aventura Hospital ... in our organization. We are looking for an enthusiastic Registered Nurse Case Mgr RN PRN to...years of critical care experience + Certification in case management or utilization review preferred + InterQual… more
- Centers Plan for Healthy Living (Margate, FL)
- …Healthy Living is currently accepting applications for Full Time Registered Nurse without experience. The Utilization Management Clinical Reviewer works ... or support in their home to improve their quality of life. Utilization Management Clinical Reviewer will assess and process all authorization requests to… 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 , Licensed Practical Nurse ...Florida. + 3 years minimum experience in discharge planning, utilization management , or case management .… more
- Molina Healthcare (Miami, FL)
- …chief medical officer on denial decisions. * Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. * ... be required. * Serves as a clinical resource for utilization management , chief medical officer, physicians, and...or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active… more
- HCA Healthcare (Miami, FL)
- …of care. **What qualifications you will need:** + Current Florida license as Registered Nurse or Recognized Compact Licensure (subject to Florida State Licensing ... within 30 days of employment start date + (RN) Registered Nurse + Minimum 1 year of...1 year of experience as a full time Charge Nurse / Coordinator, Nursing Administrative Supervisor, or Nursing Management… more
- HCA Healthcare (Aventura, FL)
- …of care. **What qualifications you will need:** + Current Florida license as Registered Nurse or Recognized Compact Licensure (subject to Florida State Licensing ... within 30 days of employment start date + (RN) Registered Nurse + Minimum 1 year of...1 year of experience as a full time Charge Nurse / Coordinator, Nursing Administrative Supervisor, or Nursing Management… more
- Molina Healthcare (Miami, FL)
- …ensure appropriate reimbursement to providers. + Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) ... modification of payment decisions. + Serves as a clinical resource for utilization management , CMOs, physicians and member/provider inquiries/appeals. + Provides… more
- Surgery Care Affiliates (Fort Lauderdale, FL)
- …specializes in Cardiac Electrophysiology, Cath Lab and Interventional Pain Management . Under general supervision, the Cardiovascular Invasive Technologist is ... the needs of the physician and keeping the circulating nurse informed of any needs throughout a procedure. +...all new equipment requests are appropriately analyzed based on utilization and data from the provider. + Maintain radiation… more
- Select Medical (Miami, FL)
- …of acute transfers and other CQI indicators. **Qualifications** **Minimum Qualifications** + Registered Nurse with valid state license. Legacy employees may ... **Location: Miami, FL** **$20,000 Sign-on Bonus** **Director of Quality Management ** **(DQM)** **Responsibilities** **Position Summary** Coordinates the Medical Quality… more
- Molina Healthcare (Miami, FL)
- …with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At ... or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active...emergency room. Previous experience in managed care Prior Auth, Utilization Review / Utilization Management … more
- Molina Healthcare (Miami, FL)
- …internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more
- Molina Healthcare (Miami, FL)
- For this position we are seeking a (RN) Registered Nurse who must be licensed for the state they reside This role will be doing Utilization review for our ... to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required...or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active… more
- Molina Healthcare (Miami, FL)
- …at least 3 or more years in one or more of the following areas: utilization management , care management , care transitions, behavioral health, or equivalent ... external vendors. * Focuses on process improvement, organizational change management , program management and other processes relative...combination of relevant education and experience. * Registered Nurse (RN), Licensed Vocational … more
- Molina Healthcare (Miami, FL)
- …at least 3 or more years in one or more of the following areas: utilization management , care management , care transitions, behavioral health, or equivalent ... external vendors. + Focuses on process improvement, organizational change management , program management and other processes relative...combination of relevant education and experience. + Registered Nurse (RN), Licensed Vocational … more
- Deloitte (Miami, FL)
- …degree in nursing, medical degree, or physician assistant required + Current Registered Nurse (RN) license required + Certified Clinical Documentation Specialist ... (CRC, CCA, CCS-P, CCS, CPC, CDIP, CCM) + Experience as clinical registered nurse , physician, physician assistant, case manager, clinical documentation… more