- University of Miami (Miami, FL)
- …Department of UMHC SCCC Business Operations has an exciting opportunity for a full time Utilization Review Case Manager to work to work remote. The incumbent ... retrospective chart reviews for clinical utilization and authorization. The Utilization Review Case Manager coordinates with the healthcare team for… more
- BayCare Health System (Tampa, FL)
- …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN responsibilities include:** + Functions ... + Preferred ACM (Case Management) + Preferred CCM (Case Manager ) **Education:** + Required Associates in Nursing or +...Nursing or Business **Experience:** + Required 2 years in Utilization Review or + Required 2 years… more
- Elevance Health (Jacksonville, FL)
- **Title: Utilization Management Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... employment, unless an accommodation is granted as required by law._ The ** Utilization Management Representative I** will be responsible for coordinating cases for… more
- Elevance Health (Miami, FL)
- ** Utilization Management Representative II** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... unless an accommodation is granted as required by law._ The ** Utilization Management Representative II** is responsible for managing incoming calls, including… more
- Deloitte (Tampa, FL)
- …+ Experience as clinical registered nurse, physician, physician assistant, case manager , clinical documentation specialist, utilization review , informatics ... RN, Quality, DRG Validation and health IT preferred + Knowledge of Medicare reimbursement system and coding structures preferred + In-depth knowledge and experience in medical terminology, medical coding, and ICD-10-CM/PCS, IPPS payment system is a plus' +… more
- Elevance Health (Tampa, FL)
- …focus on EAP and BH benefits in a clinical call center The ** Manager Behavioral Health Services** is responsible for Behavioral Health Utilization Management ... assist with implementation of cost of care initiatives. + May attend meetings to review UM and/or CM process and discusses facility issues. + Hires, trains, coaches,… more
- Adecco US, Inc. (Tallahassee, FL)
- …license accepted if current and compliant + Case Management, Nursing, or Utilization Review certification preferred **Benefits** + Comprehensive Medical, Dental, ... **Position Title:** Case Manager RN **Location:** Tallahassee, FL 32310 **Position Type:**...Case Management team. This role focuses on care coordination, utilization management, patient throughput, and discharge planning across the… more
- HCA Healthcare (Kissimmee, FL)
- …and improve the patient flow program effectiveness as it relates to utilization review , resource management, and discharge planning and care coordination. ... **Description** **Introduction** We are seeking a(an) Manager Patient Throughput with HCA Florida Osceola Hospital...leader to physicians and employees as it relates to utilization review , resource management, patient flow, multi-disciplinary… more
- HCA Healthcare (Tallahassee, FL)
- …position if current and compliant** + **Certification in Case Management, Nursing, or Utilization Review , preferred** + **Three years of nursing experience in ... supporting a balance of optimal care and appropriate resource utilization . The RN CM Care Coordinator will identify potential...we encourage you to apply for our RN Case Manager Part Time opening. We promptly review … more
- Community Health Systems (Naples, FL)
- …for the planning, coordination, and oversight of care management services, including utilization review , discharge planning, and transitions of care. The role ... efficiently, effectively, and in compliance with organizational standards. + Oversees utilization review and discharge planning processes to ensure… more