- Lincoln Financial Group (Tallahassee, FL)
- …Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management ... Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible for… more
- Centene Corporation (Tallahassee, FL)
- …findings, discharge plans, and actions taken on member medical records in health management systems according to utilization management policies and ... preferred. Knowledge of Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. **License/Certification:** + LPN -… more
- CVS Health (Tallahassee, FL)
- …in the coordination and administration of the utilization /benefit management function. Required Qualifications Registered Nurse (RN) with psychiatric ... occasional rotating weekend and holiday schedules. Preferred Qualifications Managed care/ utilization review experience preferred Experience in a behavioral… more
- Marriott (Tallahassee, FL)
- …with Claims department regarding case management . + Collaborate with UNM on utilization review issues. + Refer catastrophic cases in coordination with claims ... claims most likely to benefit from case management to meet jurisdictional needs. ** Utilization Review ** + Provide initial clinical review in order to… more
- CVS Health (Tallahassee, FL)
- …to promote effective utilization of healthcare services.* Responsible for initial review and triage of Case Management tasks. Screens patients using targeted ... system.* Support comprehensive coordination of medical services including Case Management intake, screening and supporting the implementation of care plans… more
- CenterWell (Tallahassee, FL)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...and reliable transportation. + Two years as a Registered Nurse with at least one-year of management … more
- Evolent Health (Tallahassee, FL)
- …are supported by Physician clinical review staff (MDs) in the utilization management determination process. + Reviews charts and analyzes clinical record ... Reviewer, you will be a key member of the utilization management team. We can offer you...You Will Be Doing:** + Functions in a clinical review capacity to evaluate all cases, which do not… more
- HCA Healthcare (Tallahassee, FL)
- … of Facility Scheduler. + Demonstrates accountability and effectiveness in the management of utilization of supplies and equipment. + Participates in ... goals, and objectives of the organization. Provides leadership and management of the staff in the implementation of the...legal responsibilities as written in The State of Florida Nurse Practice Act. + Conducts self as professional role… more
- MyFlorida (Tallahassee, FL)
- …Required Knowledge, Skills, and Abilities: Knowledge, skills and abilities, including utilization of equipment, required for the position: Knowledge of nursing ... and procedures; Ability to communicate effectively verbally and in writing; Ability to review , analyze and evaluate data; Ability to present information in a concise… more