- Molina Healthcare (Tampa, FL)
- …this position we are hiring for a float team to support PEGA UM systems throughout multiple states.** **JOB DESCRIPTION** **Job Summary** Molina Healthcare Services ... within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests additional information from members or providers in… more
- University of Miami (Miami, FL)
- …please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Registered Nurse works as a part of a team to ... position include, but are not limited to: Performance Nursing Duties as per Nurse Job Description 100% Perform patient interview and obtains vital signs. Assists… more
- University of Miami (Miami, FL)
- …Percent of Effort): Meets requirements of Clinical Trials Senior Chemotherapy Nurse 30% Administers research study agents, standard chemotherapy and biotherapy ... clinical protocol and clinical practice standards. Provides documentation to the Research Nurse and/or Data Manager. Meets study timelines and objectives as defined… more
- Molina Healthcare (St. Petersburg, FL)
- …Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and ... procedures that guide and support the provisions of medical staff services. Maintains a working knowledge of applicable national, state, and local laws and… more
- Humana (Tampa, FL)
- …in acute and post-acute settings. SW will facilitate case conferences, as needed, with UM team, medical directors, members and providers. SW will assist in ... Utilization Management Team. SW will work closely with internal, nurse liaison to assist in discharge planning needs of...SDOH barriers to discharge plan. SW will meet with UM nurses weekly to discuss cases with length of… more
- Molina Healthcare (Jacksonville, FL)
- …or a compact licensure. The ideal candidate will have experience with UM and prior authorization, within both Physical Health and Behavioral Health. Candidates ... within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests additional information from members or providers in… more
- Humana (Tallahassee, FL)
- …+ Serves as subject matter expert on NCQA Health Plan Accreditation UM requirements, advising stakeholders on compliance, and facilitating NCQA UM ... Health; MED-Deeming accreditation standards knowledge is a plus. + Registered Nurse or Behavioral Health Licensed Professional. + Managed care, Medicaid health… more
- ERP International (Macdill AFB, FL)
- **Overview** ERP International is seeking **Registered** ** Nurse (RN)** for Full-Time positions in **Case Management** at MacDill AFB, FL. Apply online today and ... Paid Vacation, Paid Sick Time, Plus 11 Paid Federal Holidays!** Medical /Dental/Vision, STD/LTD/Life, and Health Savings Account available!** Annual CME Stipend and… more
- Molina Healthcare (Jacksonville, FL)
- …within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests additional information from members or providers in ... teams to promote Molina Care Model + Adheres to UM policies and procedures. **JOB QUALIFICATIONS** **Required Education** Any...of the following: Completion of an accredited Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN)… more
- Molina Healthcare (St. Petersburg, FL)
- …Utilization Review Lead responsibilities also include but not limited to, collaborate with UM Leadership to ensure the Daily Auth Reconciliation Report (DARR) is run ... **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Licensed Registered Nurse (RN), Licensed Vocational Nurse (LVN), or Licensed Practical… more