• Utilization Review - Registered…

    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 ... (inpt vs OBS). Facilitates concurrent reviews and authorizations for admissions. This position will...programs + Addresses facility and departmental communication through daily review of all correspondence, including incoming email messages. +… more
    Community Health Systems (07/12/25)
    - Related Jobs
  • Registered Nurse Peer Review

    AdventHealth (Ocala, FL)
    …the team:** + Assures compliance with professional practice evaluation through concurrent and retrospective review , identification of deficiencies, and ... Practice Evaluation is responsible for facilitating the medical staff Peer Review , Ongoing Professional Practice Evaluation (OPPE) and Focused Professional Practice… more
    AdventHealth (08/08/25)
    - Related Jobs
  • Registered Nurse Digestive Health…

    AdventHealth (Riverview, FL)
    …appropriate leaders for analysis and corrective action to improve quality outcomes. Assures concurrent review is performed on those patients that may trigger ... styles. Assess organizational status in relation to assigned core measure(s) Performs concurrent data review and rounding for assigned patients within designated… more
    AdventHealth (08/07/25)
    - Related Jobs
  • Utilization Management Nurse

    Actalent (Sunrise, FL)
    …+ Prepare and present reports on department activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management + ... Actalent is hiring a Utilization Management Nurse ! Job Description The Utilization Management Nurse...Patient care + Medical record + Case management + Concurrent review + Discharge planning + Medical… more
    Actalent (08/15/25)
    - Related Jobs
  • Utilization Management Nurse Consultant

    CVS Health (Tallahassee, FL)
    …+ 1 year of varied UM (utilization management) experience within an **outpatient** setting, concurrent review or prior authorization. + 5 years of a variety ... + 1 year of varied UM (utilization management) experience within an inpatient, concurrent review or prior authorization. + Remote work experience. **Education**… more
    CVS Health (08/15/25)
    - Related Jobs
  • Acute Care Case Manager , Registered Nurse

    ChenMed (North Miami Beach, FL)
    …+ Participates in surveys, studies and special projects as assigned. + Conducts concurrent medical record review using specific indicators and criteria as ... resources and mobilizes resources to assist in achieving desired clinical outcomes within specific timeframe. + Conducts review...clinical field preferred. + A valid, active Registered Nurse (RN) license in State of employment required. +… more
    ChenMed (05/28/25)
    - Related Jobs
  • Acute Care Manager, Complex Care (Registered…

    ChenMed (Pembroke Pines, FL)
    …+ Participate in surveys, studies and special projects as assigned. + Conduct concurrent medical record review using specific indicators and criteria as approved ... we need great people to join our team. The Nurse Case Manager I position is responsible for achieving...resources and mobilizes resources to assist in achieving desired clinical outcomes within specific timeframe. + Conducts review more
    ChenMed (08/16/25)
    - Related Jobs
  • Registered Nurse Utilization Management

    AdventHealth (Tampa, FL)
    …**The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse (RN) is to use clinical expertise by analyzing patient records ... also located at AdventHealth Tampa, leads the way in clinical and academic research in the areas of neuroscience,...order or a status conflict is indicated, the UM nurse is responsible for escalation to the Physician Advisor… more
    AdventHealth (08/21/25)
    - Related Jobs
  • Acute Care Manager, Complex Care (Registered…

    ChenMed (Opa Locka, FL)
    …+ Participates in surveys, studies and special projects as assigned. + Conducts concurrent medical record review using specific indicators and criteria as ... we need great people to join our team. The Nurse Case Manager 1 (RN) is responsible for achieving...resources and mobilizes resources to assist in achieving desired clinical outcomes within specific timeframe. + Conducts review more
    ChenMed (08/16/25)
    - Related Jobs
  • Clinical Documentation Auditor

    AdventHealth (Orlando, FL)
    …Full Time **Shift** : Days **Location: Remote** **The role you'll contribute:** The Clinical Documentation Integrity Manager is a Registered Nurse and/or a ... nurses and clinical documentation specialists. This role will oversee the review processes of complex patients that vary in age and have different developments… more
    AdventHealth (08/18/25)
    - Related Jobs