- 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
- Actalent (Miami, FL)
- Job Title: Clinical Review Nurse Job Description As a Clinical Review Nurse , you will perform concurrent reviews to assess members' overall health, ... Essential Skills + Proficiency in utilization management and utilization review + Experience with Interqual and Medicare ...utilization review + Experience with Interqual and Medicare + Expertise in medical, acute care, concurrent … more
- Veterans Affairs, Veterans Health Administration (Miami, FL)
- Summary The Miami VA medical Center is looking for recruit for an Registered Nurse - Supervisor/Assistant Nurse Manager, for our Nursing Nursing GEC who ... specific components. Responsibilities VA offers a comprehensive total rewards package: VA Nurse Total Rewards The Nursing Supervisor/Assistant Nurse Manager for… more
- CenterWell (Port Saint Lucie, FL)
- **Become a part of our caring community and help us put health first** The Nurse Practitioner (NP) works in our team-based care environment. We are a value based ... team consists of doctors, advanced practice professionals, Pharm D, Care Coach Nurse , MA, Behavioral health specialist, Quality based Coder, Referral Coordinator and… more
- CenterWell (Plant City, FL)
- …part of our caring community and help us put health first** The Nurse Practitioner applies advanced education and clinical competencies to achieve optimal patient ... outcomes. The Nurse Practitioner works on problems of diverse scope and...leadership. + Meets with RMD about quality of care, review of outcome data, policy, procedure and records issues.… more
- Gentiva (Plantation, FL)
- …encounter? If so, you may be the perfect fit for our Hospice Nurse Practitioner opportunity. You'll report directly to the Executive Director or Administrator and ... terminal diagnosis, in accordance with CMS requirements. **As a Hospice Nurse Practitioner, You Will:** + Perform and document comprehensive physical assessments… more
- Actalent (Sunrise, FL)
- Actalent is hiring a Utilization Management Nurse ! Job Description The Utilization Management Nurse (UMN) collaborates closely with the interdisciplinary team to ... in complex cases, develops internal processes, and educates physicians on utilization review issues. The role involves managing continuity of care, ensuring smooth… more
- AdventHealth (Orlando, FL)
- …patient and involved care givers (as permitted by the patient) as well as a review of the current and past inpatient and outpatient medical record in the Initial ... and updates, as needed. Actively participates in daily Multidisciplinary Rounds to review progression of care and discharge plan for all assigned patients.… more
- CVS Health (Tallahassee, FL)
- …advocates for members who cannot advocate for themselves. The TOC team will review prior claims to address potential impact on current case management and ... Qualifications** + Candidate must have an active and unrestricted Compact Licensed Practical Nurse (LPN) License in state of residence + 3+ years of Licensed… more
- CenterWell (Tallahassee, FL)
- …off-days during the week.** The **Clinical Care Coordinator/Care Manager, Telephonic Nurse ** helps to ensure optimal continuity of care for patients transitioning ... and under established performance criteria. This is a work-from-home telephonic nurse position **Essential Functions:** + Act as CenterWell Home Health… more