- BayCare Health System (Tampa, FL)
- …appraisals + Community discounts and more Equal Opportunity Employer Veterans/Disabled **Position** Utilization Review RN **Location** Tampa:St Josephs | ... of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/ RN responsibilities...+ **On Call:** No **Certifications and Licensures:** + Required RN ( Registered Nurse ) + Preferred… more
- Molina Healthcare (Tampa, FL)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... Experience Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG… more
- Molina Healthcare (Tampa, FL)
- … and/or coding experience, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The Medical Claim Review Nurse provides support for medical...a hospital setting, including at least 1 year of utilization review , medical claims review ,… more
- Molina Healthcare (Tampa, FL)
- …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... hours 6 AM to 6 PM (Team will work on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing… more
- Molina Healthcare (Tampa, FL)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more
- AdventHealth (Tampa, FL)
- …Qualifications The expertise and experiences you'll need to succeed: .Associate Degree Nursing or RN Diploma degree. .Florida Registered Nurse ( RN ) ... well-balanced work life balance The role you'll contribute: The RN Care Manager in collaboration with the patient/family, social....Two (2 ) years of medical/hospital Registered Nurse experience This facility is an equal opportunity employer… more
- AdventHealth (Tampa, FL)
- …- Nursing or RN Diploma degree Two (2 ) years of hospital Registered Nursing experience State specific RN license This facility is an equal opportunity ... heart failure, cancer and other diseases. **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses,… more
- Adecco US, Inc. (Tampa, FL)
- …setting. **PREFERRED QUALIFICATIONS** : + Previous comprehensive care continuum management, utilization review or discharge planning experience. + HMO experience ... with our client in Florida to hire a Telecommute RN Case Manager for their facility. Candidates **MUST** reside...the cost consequences resulting from care delivery decisions through utilization of reports and systems such as Health Plan… more
- MyFlorida (Land O' Lakes, FL)
- …that all verbal orders, including telephone orders from attending physicians are received by a registered nurse . If no RN is available, receive all telephone ... SENIOR REGISTERED NURSE SUPV - 50000070 Date:...current status and providing supervision and guidance to the RN , LPN, CNA and other Allied Health Care Professionals.… more
- AdventHealth (Tampa, FL)
- …experiences you'll need to succeed:** Associate and 2 years experience Associates Degree Nursing or RN Diploma degree. Registered Nurse ( RN ). 2 years of ... support a well-balanced work life balance **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses,… more
- AdventHealth (Wesley Chapel, FL)
- …Qualifications **The expertise and experiences you'll need to succeed:** Associates Degree Nursing or RN Diploma degree. Registered Nurse ( RN ). State ... residents in west and central Pasco. **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses, physicians… more
- AdventHealth (Tampa, FL)
- …**The expertise and experiences you'll need to succeed:** Associate's of Nursing Required Registered Nurse ( RN ) Required Basic Life Support - CPR ... Participates in conducting performance appraisals for personnel on assigned shift. The Registered Nurse provides self-directed, effective nursing care to groups… more
- AdventHealth (Zephyrhills, FL)
- …care. **The expertise and experiences you'll need to succeed:** Associates Degree Nursing or RN Diploma degree Registered Nurse ( RN ) Two (2) ... Care) Premium shopping outlets **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social...a hospital setting + One (1) year experience of utilization review This facility is an equal… more
- HCA Healthcare (St. Petersburg, FL)
- …charitable organizations. Apply Today! **Job Summary and Qualifications** We are seeking a Registered Nurse Case Manager. You will provide clinical expertise to ... promote cost effectiveness through the integration of case management, utilization review management and discharge planning. **What...we encourage you to apply for our Case Manager RN PRN opening. We promptly review all… more
- HCA Healthcare (St. Petersburg, FL)
- …goals. Unlock your potential! **Job Summary and Qualifications** We are seeking a Registered Nurse Case Manager. You will provide clinical expertise to ensure ... You will promote cost effectiveness through the integration of case management, utilization review management and discharge planning. **What qualifications you… more
- HCA Healthcare (Lakeland, FL)
- …communicates financial and performance measurements as a gauge of standardization/ utilization success + Maintains comprehensive cross references to support product ... team in resolution of issues What qualifications you will need: + ** RN - Bachelor's degree in Nursing, Business Management, Healthcare Administration, or Finance… more
- Elevance Health (Tampa, FL)
- …following standard procedures that do not require the training or skill of a registered nurse . **How you will make an impact:** + Confirms medical services ... a minimum of 2 years of clinical experience and/or utilization review experience. + Current active, valid...experience. + Current active, valid and unrestricted LPN/LVN or RN license and/or certification to practice as a health… more
- Elevance Health (Tampa, FL)
- …following standard procedures that do not require the training or skill of a registered nurse . **How You Will Make an Impact** Primary duties may include, ... a minimum of 2 years of clinical experience and/or utilization review experience. + Current active, valid...experience. + Current active, valid and unrestricted LPN/LVN or RN license and/or certification to practice as a health… more
- HCA Healthcare (Sun City Center, FL)
- …related field required; Master's Degree preferred . Current Florida licensure as a Registered Nurse preferred _**If serving as facility's primary Risk Manager, ... Quality) OR CHCQM (Diplomate in American Board of Quality Assurance and Utilization Review Physicians) _Individuals without CPHQ or ABQUARP will be granted a 12… more
- AdventHealth (Wesley Chapel, FL)
- …Works with appropriate representatives from other clinical delivery units, finance, utilization review , social services, admissions, and medical staff to ... enrolled in and pursuing either of those degrees + Active and Unrestricted Registered Nurse or Paramedic license + ACLS Advanced Cardiac Life Support + BCLS… more