- 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 ... (Team will work on set schedule) Looking for a RN with experience with appeals, claims review ,...clinical nursing experience, including at least 1 year of utilization review , medical claims review ,… more
- Molina Healthcare (St. Petersburg, FL)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... unit (ICU) or emergency room. Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG… 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
- CenterWell (Tampa, 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...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… 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
- 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
- Molina Healthcare (St. Petersburg, FL)
- …claims review , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... JOB DESCRIPTION Job Summary The RN Lead, DRG Coding/Validation provides lead level support...* Performs clinical reviews of medical records and other utilization management documentation to evaluate issues of coding and… more
- Fresenius Medical Center (St. Petersburg, FL)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- MyFlorida (Land O' Lakes, FL)
- …that all verbal orders, including telephone orders from attending physicians are received by a registered nurse . If no RN is available, receive all telephone ... SENIOR REGISTERED NURSE SUPV - 50000070 Date:...current status and providing supervision and guidance to the RN , LPN, CNA and other Allied Health Care Professionals.… 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 (Trinity, 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 opening. We promptly review all applications.… 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 (Hudson, 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 (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)
- …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
- Battelle Memorial Institute (Tampa, FL)
- …two years' nursing experience + Current, full, active, and unrestricted license as a Registered Nurse in any US State, the District of Columbia, Guam, Puerto ... (HRA) business line is seeking a highly motivated, full-time ** Nurse Case Manager** to join our team in support...professional parameters + Knowledge and skill in using pre-established utilization review criteria to recognize and report… more
- Elevance Health (Tampa, FL)
- …or case management experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or any combination of education ... EST for at least three weeks. The **Medical Management Nurse ** will be responsible for review of...an equivalent background. + Current active, valid and unrestricted RN license and/or certification to practice as a health… more
- HCA Healthcare (Trinity, FL)
- …related field required; Master's Degree preferred .Current Florida licensure as a Registered Nurse preferred _**If serving as facility's primary Risk Manager, ... Quality) OR CHCQM (Diplomate in American Board of Quality Assurance and Utilization Review Physicians) _Individuals without CPHQ or ABQUARP will be granted a 12… more