- Actalent (Sunrise, FL)
- Utilization Management Nurse !Job Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing service authorization requests to ensure ... staff to direct utilization and capture data effectively. Responsibilities + Review prior authorization requests for medical necessity and appropriateness, utilizing… more
- Ascension Health (Pensacola, FL)
- …plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance programs (EAP) Parental leave & adoption assistance ... health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests within assigned… more
- Centene Corporation (Tallahassee, FL)
- …a fresh perspective on workplace flexibility. **Centene is Hiring - Remote Clinical Review Nurse (Prior Authorization)!** **Ready to take your nursing career ... criteria + Works with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care +… more
- CVS Health (Tallahassee, FL)
- …a collaborative process to implement, coordinate, monitor and evaluate medical review cases. + Applies the appropriate clinical criteria/guideline and plan language ... thinking, evidenced based clinical criteria and clinical practice guidelines. Med Review nurses use specific criteria to authorize procedures/services or initiate a… more
- 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 ... improvement programs + Addresses facility and departmental communication through daily review of all correspondence, including incoming email messages. + Performs… more
- Centene Corporation (Tallahassee, FL)
- …criteria + Works with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care + ... care to members + Provides feedback on opportunities to improve the authorization review process for members + Performs other duties as assigned + Complies with… more
- AdventHealth (Ocala, FL)
- …Practice Evaluation is responsible for facilitating the medical staff Peer Review , Ongoing Professional Practice Evaluation (OPPE) and Focused Professional Practice ... Practice Evaluation Policy. This includes the analysis of events that require peer review and the examination of medical records as identified by clinical indicators… more
- Veterans Affairs, Veterans Health Administration (Bay Pines, FL)
- Summary The Assistant Chief Nurse executes leadership that is characterized by substantial and continuous responsibility and accountability for population groups or ... and quality of care of the Veteran being the focus. The Assistant Chief Nurse assists with overseeing the timely and accurate completion of all recruitment and… more
- MyFlorida (Land O' Lakes, FL)
- SENIOR LICENSED PRACTICAL NURSE - 50000083 1 Date: Aug 4, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... Requisition No: 857808 Agency: Veterans Affairs Working Title: SENIOR LICENSED PRACTICAL NURSE - 50000083 1 Pay Plan: Career Service Position Number: 50000083… more
- HCA Healthcare (Largo, FL)
- …RN Registered Nurse Float Pool opening. Our team will promptly review your application. Highly qualified candidates will be contacted for interviews. **Unlock ... we support our colleagues in their positions. Join our Team as a(an) RN Registered Nurse Float Pool and access programs to assist with every stage of your career.… more