- 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 (St. Petersburg, 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 (St. Petersburg, 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 (St. Petersburg, 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
- BayCare Health System (Bradenton, FL)
- …care goals. + Knowledge of regulatory standards appropriate to position. **Requirements:** + RN ( Registered Nurse ) License + Driver's License, State of ... Career with BayCare HomeCare as a Home Care Supervisor, RN ! At BayCare, we are proud to be one...area of responsibility. + Ensure quality assurance program and utilization review is followed in accordance with… more
- BayCare Health System (Dunedin, FL)
- …with 1 year Home Health RN visit experience. **Required Credentials:** + RN ( Registered Nurse ) License + Diploma, Associate's or Bachelor's Nursing ... regulatory bodies within the area of responsibility + Ensure quality assurance program and utilization review is followed in accordance with Home Care protocol +… 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
- 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 (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
- 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 (Largo, FL)
- …goals. Unlock your potential! **Job Summary and Qualifications** We are seeking a Registered Nurse Case Manager. You will provide clinical expertise to ensure ... hours volunteering in our communities. As a(an) Case Manager RN with HCA Florida Largo Hospital you can be...promote cost effectiveness through the integration of case management, utilization review management and discharge planning. **What… more
- HCA Healthcare (Bradenton, FL)
- …be a part of our team. **Job Summary and Qualifications** We are seeking a Registered Nurse Case Manager. You will provide clinical expertise to ensure all ... organization that invests in you as a(an) Case Manager RN ? At HCA Florida Blake Hospital, you come first....promote cost effectiveness through the integration of case management, utilization review management and discharge planning. **What… more
- HCA Healthcare (Brandon, FL)
- …be a part of our team. **Job Summary and Qualifications** We are seeking a Registered Nurse Case Manager. You will provide clinical expertise to ensure all ... organization that invests in you as a(an) Case Manager RN ? At HCA Florida Brandon Hospital, you come first....promote cost effectiveness through the integration of case management, utilization review management and discharge planning. **What… more
- HCA Healthcare (Largo, FL)
- …Healthcare Quality) OR CHCQM (Diploma in American Board of Quality Assurance and Utilization Review Physicians). _Individuals without CPHQ or_ CHCQM _will be ... our Director, you will provide direction to ensure the facilitation and utilization of diverse strategies and communication for quality and performance improvement… more
- Elevance Health (Tampa, FL)
- …4 years managed care experience and requires a minimum of 2 years clinical, utilization review , or case management experience; or any combination of education ... is granted as required by law. The **Medical Management Nurse ** is responsible for review of the...an equivalent background. + Current active, valid and unrestricted 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:** + 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