- Molina Healthcare (St. Petersburg, FL)
- …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... program(s) proficiency. Preferred Experience Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review... Care , ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual /… more
- Molina Healthcare (St. Petersburg, FL)
- …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary… more
- Molina Healthcare (St. Petersburg, FL)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
- BayCare Health System (Largo, FL)
- … Supervisor **Home Health RN Requirements:** + BLS (Basic Life Support) + RN ( Registered Nurse ) License + Driver's License State of Florida (Florida ... Care is seeing a skilled **Home Health Field, RN ** to join our team who is passionate about...Required Associate's or Diploma Nursing + Required 1 year Registered Nurse + _Preferred_ Bachelor's Nursing +… more
- BayCare Health System (Largo, FL)
- … Supervisor **Home Health RN Requirements:** + BLS (Basic Life Support) + RN ( Registered Nurse ) License + Driver's License State of Florida (Florida ... by home base zip code) The Home Health Field RN provides hands-on care in the home...+ Required Associate's or Diploma Nursing + Required 1-year Registered Nurse or 1-year Licensed Practical … more
- Zelis (St. Petersburg, FL)
- …Clinical Chart Review is focused on supervising a team of Clinician 's performing clinical reviews of facility claims, including UB's, Itemized Bills and medical ... and proven leadership experience is a must as recommendations to the Nurse Reviewer's regarding their claim management is required. Additionally, this role is… more
- Elevance Health (Tampa, FL)
- …employment, unless an accommodation is granted as required by law. The **Medical Management Nurse ** is responsible for review of the most complex or challenging ... **Medical Management Nurse ** **Hours: Candidates will work 8a-5pm PST with...not be receiving appropriate type, level, or quality of care , eg, if services are not in line with… more