- Humana (Tallahassee, FL)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Humana (Tallahassee, FL)
- …Work hours will be an 8.5-hour shift between 7:00am - 5:00pm CST. The Utilization Management Nurse 2 uses knowledge, communication, and independent critical ... Qualifications** + Associate's Degree or higher + Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary...a team **Preferred Qualifications** + BSN + Knowledge of Utilization Management + Previous Medicare and Medicaid… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CVS Health (Tallahassee, FL)
- …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in Eastern or Central time… more
- CenterWell (Tallahassee, FL)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Cognizant (Tallahassee, FL)
- …background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- CenterWell (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... **Required Qualifications** + Must be a licensed Registered Compact Nurse license (RN) with no disciplinary action and ability...volume and fast paced environment + Previous experience in utilization management + Education: BSN or bachelor's… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... and communication of behavioral health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work… more
- Sharecare (Tallahassee, FL)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
- MyFlorida (Monticello, FL)
- COMMUNITY HEALTH NURSE - 64005037 Date: Nov 5, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... Requisition No: 861861 Agency: Department of Health Working Title: COMMUNITY HEALTH NURSE - 64005037 Pay Plan: Career Service Position Number: 64005037 Salary:… more
- Humana (Tallahassee, FL)
- …experience in an acute care, skilled or rehabilitation setting, home health, DME, triage, utilization , or case management . + **Ability to work ANY 8-hour shift ... caring community and help us put health first** The Nurse Advice Line is a fast-paced inbound call center...+ Bachelor's degree in nursing (BSN) + Previous case management , utilization review, or triage experience +… more
- HCA Healthcare (Tallahassee, FL)
- …**Introduction** Do you have the PRN career opportunities as an Operating Room Nurse PRN-Surgery Center you want with your current employer? We have an exciting ... Do you want to work as an Operating Room Nurse PRN-Surgery Center where your passion for creating positive...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… more
- HCA Healthcare (Tallahassee, FL)
- …passionate about delivering patient-centered care?** Submit your application for Operating Room Nurse - Surgery Center position and spend more time at the bedside ... to deliver clinical excellence behind the scenes in data science, case management or transfer centers. Unlock your potential at Tallahassee Outpatient Surgery… more
- Highmark Health (Tallahassee, FL)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... within the first 6 months of employment. **Preferred** + Certification in utilization management or a related field + Certification in Case Management … more
- MTC (Quincy, FL)
- …record or other forms as appropriate. + Practice basic cost containment and utilization management for inmate care and facility operations. + Maintain absolute ... of Florida with an acceptable driving record required, unless waived by management . Management & Training Corporation (MTC) is an Equal Opportunity Employer. All… more
- HCA Healthcare (Tallahassee, FL)
- **Description** **Introduction** Do you have the career opportunities as a(an) Manager Case Management you want in your current role? We invest in what matters most ... meet these needs. + Develops, initiates, and coordinates individual patient case management plans to ensure appropriate level of care across the continuum. Ensures… more
- CVS Health (Tallahassee, FL)
- …with heart, each and every day. **Position Summary** As a Care Management Associate you will be supporting comprehensive coordination of medical services including ... and supporting the implementation of care plans to promote effective utilization of health services service. Promotes/supports quality effectiveness of Healthcare… more
- HCA Healthcare (Tallahassee, FL)
- …and assess observation patients for appropriateness in observation status + Performs utilization management reviews and communicates information to third party ... location._** It is an exciting time to be a nurse at HCA Healthcare! Come unlock your career potential...position if current and compliant** + **Certification in Case Management , Nursing, or Utilization Review, preferred** +… more