- 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
- 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
- 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
- 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
- Molina Healthcare (Miami, FL)
- …and cost-effective member care. The candidate must have Medicare Appeals and/or Utilization Management knowledge. Work hours are Monday-Friday 8:00am- 5:00pm ... 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)
- For this position we are seeking a (RN) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity of ... 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
- University of Miami (Miami, FL)
- …responsibilities as necessary. CORE QUALIFICATIONS + Bachelor's degree in relevant field + Registered Nurse Licensure (RN), BLS, and ACLS Provider Card. + ... The Manager, Nursing promotes and restores patients' health by developing day-to-day management and long-term planning of the patient care area, directing and… more
- ChenMed (Miami, FL)
- …in area of specialty required; Master's degree in Nursing required. + Valid, active Registered Nurse license required + For NPs: Board certification by AANP or ... trends in patient conditions and develops, documents and implements a patient management plan based on interpretation of findings. Aids in the development of… more
- University of Miami (North Miami, FL)
- …CORE QUALIFICATIONS Education: Bachelor of Science in nursing Certification and Licensing: Registered nurse license Experience: Minimum 5 years of relevant ... FUNCTIONS Creates and assesses the daily schedule to plan optimal staff utilization and functioning of the operative schedule. Maintains effective lines of… 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 ... authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in… 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 ... authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in… more