- Elevance Health (Tampa, FL)
- Senior RN Utilization Review / Management (Acute InPatient) JR116937 **Location:** Must be within 50 miles / 1 hour commute of Tampa or Miami, FL offices. This ... Friday. **2 Holidays** per year and **occasional** weekends. The ** Nurse Medical Management Sr** serves as **team...preferred** . + 2 years of experience in In-Patient, utilization review / management , evaluating… more
- HCA Healthcare (Largo, FL)
- …of care and cost effectiveness through the integration of case management and utilization review management . We are an amazing team that works hard ... over 156,000 hours volunteering in our communities. As a(an) Utilization Review RN with HCA Florida Largo...health care experience . Licensure as a Florida Registered Nurse in accordance with state regulations or appropriate compact… more
- Elevance Health (Tampa, FL)
- **Clinical Operations Medical Director** ** Utilization Management of Medical Oncology Benefits** **Carelon Benefits Management ** **$20,000 Sign On Bonus** ... members and providers. **Job Summary:** + Perform physician-level case review , following initial nurse review ,...maintain knowledge of relevant policies and regulations pertaining to utilization review of oncology care. + Participate… more
- Centene Corporation (Tampa, FL)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
- AdventHealth (Tampa, FL)
- …Association as a Primary Stroke Center. **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse (RN) is to use clinical ... reviews within 24 hours of admission; and when warranted by length of stay, utilization review plan, and/or best practice guidelines, on a continuing basis. .… more
- MyFlorida (Land O' Lakes, FL)
- SENIOR LICENSED PRACTICAL NURSE - 50000086 1 Date: May 21, 2024 Location: LAND O' LAKES, FL, US, 34639 The State Personnel System is an E-Verify employer. For more ... Requisition No: 819687 Agency: Veterans Affairs Working Title: SENIOR LICENSED PRACTICAL NURSE - 50000086 1 Pay Plan: Career Service Position Number: 50000086… more
- AdventHealth (Riverview, FL)
- …patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the interdisciplinary team ... core competencies of this role. The RN Care Manager facilitates the collaborative management of patient care across the continuum, intervening to remove barriers to… more
- Fresenius Medical Center (St. Petersburg, FL)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- VIP Care (Tampa, FL)
- …+ 3 or more years of managed care experience + Experience in Utilization Management and Physician Improvement Programs + Experience in Medicare Advantage ... Director is responsible for leading efforts to develop and implement medical management and performance improvement strategies to ensure success in our existing… more
- CenterWell (Tampa, FL)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...and reliable transportation. + Two years as a Registered Nurse with at least one-year of management … more
- BayCare Health System (New Port Richey, FL)
- …regulatory bodies within the area of responsibility. Ensure quality assurance program and utilization review is followed in accordance with Home Care protocol. ... Oversees and investigates patient and physician concerns, risk management concerns and implements changes and training where necessary....Participates with Case Manager on initial Plan of Care review with a focus on quality, utilization … more
- BayCare Health System (Largo, FL)
- …bodies within the area of responsibility. + Ensure quality assurance program and utilization review is followed in accordance with Home Care protocol. + ... Oversees and investigates patient and physician concerns, risk management concerns and implements changes and training where necessary....Participates with Case Manager on initial Plan of Care review with a focus on quality, utilization … more
- BayCare Health System (New Port Richey, FL)
- …bodies within the area of responsibility. + Ensure quality assurance program and utilization review is followed in accordance with Home Care protocol. + ... Oversees and investigates patient and physician concerns, risk management concerns and implements changes and training where necessary....Participates with Case Manager on initial Plan of Care review with a focus on quality, utilization … more
- BayCare Health System (New Port Richey, FL)
- …regulatory bodies within the area of responsibility + Ensure quality assurance program and utilization review is followed in accordance with Home Care protocol + ... a great place to work!** **Requirements:** + RN (Registered Nurse ) License + Driver's License, State of Florida required...Participates with Case Manager on initial Plan of Care review with a focus on quality, utilization … more
- HCA Healthcare (Brandon, FL)
- …step in your career path, we encourage you to apply for our RN Clinical Nurse Coordinator Med OR opening. We review all applications. Qualified candidates will ... you have the career opportunities as a(an) RN Clinical Nurse Coordinator OR you want in your current role?...and in accordance with established policies. + Surgical Schedule Management : + Coordinate and manage the surgical schedule, ensuring… more
- HCA Healthcare (St. Petersburg, FL)
- …and satisfaction. + You will promote cost effectiveness through the integration of case management , utilization review management and discharge planning. ... The CM collaborates with the Rehab Program Director and Facility Case Management Director regarding departmental functions. The CM coordinates efforts within the… more
- HCA Healthcare (St. Petersburg, FL)
- …and satisfaction. + You will promote cost effectiveness through the integration of case management , utilization review management and discharge planning. ... and expertise! **Job Summary and Qualifications** We are seeking a Registered Nurse Case Manager. You will provide clinical expertise to ensure all patients… more
- Grifols Shared Services North America, Inc (Clearwater, FL)
- …Pharmacists, DOP, Physician, therapeutic departments, ADR/SP Partner, Infusion Suite Nurse , etc.) * Demonstrate account-based selling skills (including group ... to submit and approve P&T requests to add product to formulary * Utilization of Managed Markets, Marketing, IgNE, MSL, etc. * Detailing customers including Primary… more
- HCA Healthcare (Brandon, FL)
- …and satisfaction. + You will promote cost effectiveness through the integration of case management , utilization review management and discharge planning. ... **Job Summary and Qualifications** We are seeking a Registered Nurse Case Manager. You will provide clinical expertise to...apply for our Case Manager RN opening. We promptly review all applications. Highly qualified candidates will be contacted… more
- HCA Healthcare (Sun City Center, FL)
- …and satisfaction. + You will promote cost effectiveness through the integration of case management , utilization review management and discharge planning. ... **Job Summary and Qualifications** We are seeking a Registered Nurse Case Manager. You will provide clinical expertise to...for our Case Manager RN PRN opening. We promptly review all applications. Highly qualified candidates will be contacted… more