- Community Health Systems (Naples, FL)
- **Job Summary** Under the direction of the UR Director/ Manager the UR Nurse reviews all admissions for medical necessity, correct orders based on medical condition ... Medical Record + Works with healthcare providers to ensure complete and accurate condition and care of the patient + Serves as a resource to support the UR team in… more
- CenterWell (Tallahassee, FL)
- …member service or customer service telephone experience desired + Experience with Utilization Review and/or Prior Authorization, preferably within a managed ... of our caring community and help us put health first** The Utilization Management (UM) Administrative Coordinator 2 is responsible for providing high-quality support… more
- CenterWell (Tallahassee, FL)
- …and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... of three years clinical RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional… more
- CenterWell (Tallahassee, FL)
- …and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... of three years clinical RN experience; + Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience +… more
- BAYADA Home Health Care (Orlando, FL)
- …around this requirement.** BAYADA Home Health Care is hiring a full time OASIS Review and Coding Manager . The OASIS and Coding Review Manager ... Minimum of 1 year experience with coding and OASIS review . + Knowledge of OASIS, Home Care ...should be available Monday-Friday from 8:30am-5:00pm. _Medicare, Coder, OASIS Review , Utilization Review , Quality Assurance,… more
- ChenMed (North Miami Beach, FL)
- …assess and record patients' progress and adjust and plan accordingly. + Understanding utilization review and how to leverage with inpatient staff for possible ... your kindness and joy? We're different than most primary care providers. We're rapidly expanding and we need great...experience required. + A minimum of 1 year of utilization review and/or case management, home health,… more
- Actalent (Sunrise, FL)
- …+ Prepare and present reports on department activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management + ... policy guidelines. + Promote safe and appropriate coordination of care and optimal utilization of resources. +...or LPN License. + Minimum of one year of utilization review experience and discharge planning in… more
- AdventHealth (Winter Garden, FL)
- …the mind, body, and spirit! **The role you'll contribute** **:** The RN Care Manager in collaboration with the patient/family, social workers, nurses, physicians ... care coordination and progression through the continuum of care . The RN Care Manager ...needed. + Actively participates in daily Multidisciplinary Rounds to review progression of care and discharge plan… more
- AdventHealth (Altamonte Springs, FL)
- …leadership and world-class resource **The role you'll contribute** **:** The RN Care Manager in collaboration with the patient/family, social workers, nurses, ... care coordination and progression through the continuum of care . The RN Care Manager ...needed. + Actively participates in daily Multidisciplinary Rounds to review progression of care and discharge plan… more
- BAYADA Home Health Care (Orlando, FL)
- …Health Care has an immediate opening for a **Full Time,** OASIS and Coding Review Manager with OASIS and Coding certification to work remotely. RN, PT, OT, ... your career with an industry leader. Apply now for immediate consideration. OASIS Review , Utilization Review , Quality Assurance, Remote, Home Health Coding,… more