- Healthfirst (FL)
- The Case Manager , Utilization Management coordinates the care plan for assigned members and conducts pre-certification, concurrent review , discharge ... planning, and case management as assigned. The Case Manager , Utilization Management is also responsible for efficient utilization of health services… more
- CenterWell (Deland, FL)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... delivery, and documentation requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance … more
- CVS Health (Tallahassee, FL)
- …level. The Associate Manager is also responsible for oversight of utilization management nurses including the organization and development of high performing ... some rotational on-call holiday coverage as needed. The Associate Manager is accountable to support the day to day...compliance and privacy practices. + Oversees the implementation of utilization management services for assigned area +… more
- AssistRx (Orlando, FL)
- The Copay Support Program Manager is a critical role within the organization and is primarily responsible for the creation, design, set-up and administration of ... and financial processes related to claim processing activities. In addition, manager will ensure effective day-to-day operations and provide ongoing Copay program… more
- University of Miami (Miami, FL)
- …and utilization of data used by all levels of management within the organization.5. Interacts, communicates, and intervenes with multidisciplinary healthcare ... utilization and prevent loss of reimbursement.UNIVERSITY OF MIAMICore_Sr. Manager , Financial Counseling11. Utilizes financial and decision support systems to… more
- HCA Healthcare (Gainesville, FL)
- …Case Management is preferred + BSN is preferred + Certification in Case Management , Nursing or Utilization Review is preferred HCA Florida North Florida ... patients, families, hospital staff, and outside agencies + Performs utilization management reviews and communicates information to...we encourage you to apply for our RN Case Manager PRN opening. We promptly review all… more
- Adecco US, Inc. (Altamonte Springs, FL)
- …Previous experience in an acute clinical care setting or equivalent. . Previous care management , utilization review or discharge planning experience. . RN ... & Life Sciences is looking for an **RN Case Manager ** for our client in **Altamonte Springs, FL** !...thorough understanding of the cost consequences resulting from Care Management decisions through utilization of reports and… more
- AdventHealth (Orange City, FL)
- …of Nursing. + Health-related Master's degree or MSN. + Prior Care Management / Utilization Management experience. + ACM/CCM Certification. This facility ... is under the general supervision of the Care Management Supervisor or Manager or Director of...physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge… more
- AdventHealth (Deland, FL)
- …+ BSN + Health-related Master's degree or MSN + Prior Care Management / Utilization Management experience ACM/CCM Certification This facility is ... transitions, patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the… more
- HCA Healthcare (Sanford, FL)
- …in Case Management is preferred + BSN is preferred + Certification in Case Management , Nursing or Utilization Review is preferred HCA Florida Lake Monroe ... organization that invests in you as an RN Case Manager PRN? At HCA Florida Lake Monroe Hospital, you...patients, families, hospital staff, and outside agencies + Performs utilization management reviews and communicates information to… more