- Actalent (Sunrise, FL)
- Actalent is hiring a Utilization Management Nurse! Job Description The Utilization Management Nurse (UMN) collaborates closely with the interdisciplinary ... present reports on department activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management + InterQual + Milliman… more
- Actalent (Sunrise, FL)
- …service utilization . Working under the general supervision of the Director and/or Manager/Supervisor of Medical Management , and in collaboration with ... Utilization Management Nurse!Job Description The ...utilizing standardized Review Criteria. + Coordinate with the Medical Director /Physicians for requests outside standard Review Criteria. + Maintain… more
- CVS Health (Tallahassee, FL)
- …Review nurses use specific criteria to authorize procedures/services or initiate a Medical Director referral as needed. + Assists management with training new ... (RN) - active license. + 3+ Years of clinical experience. + 1+ Year of Utilization Review Management and/or Medical Management experience. + Must have active… more
- CenterWell (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The National Director , Care Integration Strategy & Program will be responsible for the ... , safe transitions, readmission reduction, and other clinical programs as determined. The National Director , Care Integration Strategy & Program is a critical… more
- Humana (Tallahassee, FL)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- Evolent (Tallahassee, FL)
- …Clinical Reviewer, Interventional Pain Management , you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... for selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical… more
- Select Medical (Gainesville, FL)
- …focus on resource management . + Demonstrating compliance with facility-wide Utilization Management policies and procedures. + Coordinating UR compliance with ... **Overview** **Critical Illness Recovery Hospital** ** Director of Case Management ** **$10,000 Sign...growth of the department, including, but not limited to: Utilization Review (UR) and resource management , discharge… more
- HCA Healthcare (Tampa, FL)
- …a part of our team. **Job Summary and Qualifications** The Facility Case Management Director has the overall responsibility for managing and coordinating ... join an organization that invests in you as a Director Case Management ? At HCA Florida South...to ensure continuity of care and optimal clinical resource utilization . The Director has oversight for all… more
- HCA Healthcare (Kissimmee, FL)
- …charitable organizations. Apply Today! **Job Summary and Qualifications** The Facility Case Management Director has the overall responsibility for managing and ... We care like family! Jump-start your career as a Director Case Management today with HCA Florida...to ensure continuity of care and optimal clinical resource utilization . The Director has oversight for all… more
- AdventHealth (Altamonte Springs, FL)
- …FL **The role you will contribute:** The Physician Advisor provides primary support for Utilization Management (UM) and secondary support for Care Management ... Physician Advisor is responsible for educating, informing and advising members of the Utilization Management , Care Management , Managed Care and Revenue Cycle… more