- Actalent (Sunrise, FL)
- Utilization Management Nurse !Job Description The ...on department activities as assigned. Essential Skills + Clinical review + Utilization review + ... utilization . Working under the general supervision of the Director and/or Manager/Supervisor of Medical Management, and in collaboration...or LPN License. + Minimum of one year of utilization review experience and discharge planning in… more
- CVS Health (Tallahassee, FL)
- …(RN) - active license. + 3+ Years of clinical experience. + 1+ Year of Utilization Review Management and/or Medical Management experience. + Must have active and ... a collaborative process to implement, coordinate, monitor and evaluate medical review cases. + Applies the appropriate clinical criteria/guideline and plan language… more
- Actalent (Sunrise, FL)
- …UMN assists in complex cases, develops internal processes, and educates physicians on utilization review issues. The role involves managing continuity of care, ... Actalent is hiring a Utilization Management Nurse ! Job Description The...on department activities as assigned. Essential Skills + Clinical review + Utilization review +… more
- ChenMed (Pembroke Pines, FL)
- …engagement with patient and family. + Facilitate patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... we need great people to join our team. The Nurse Case Manager I position is responsible for achieving...achieving desired clinical outcomes within specific timeframe. + Conducts review for appropriate utilization of services from… more
- Molina Healthcare (St. Petersburg, FL)
- …the Chief Medical Officer. + Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the ... and interacts with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource… more
- HCA Healthcare (Kissimmee, FL)
- …and external agencies to ensure continuity of care and optimal clinical resource utilization . The Director has oversight for all aspects of daily hospital ... through actively engaging interdisciplinary teams and external stakeholders. The Director is a registered nurse with responsibility...personal growth, we encourage you to apply for our Director Case Management opening. We promptly review … more
- Select Medical (Gainesville, FL)
- …and professional growth of the department, including, but not limited to: Utilization Review (UR) and resource management, discharge planning, treatment plan ... **Overview** **Critical Illness Recovery Hospital** ** Director of Case Management** **$10,000 Sign On Bonus**...**$10,000 Sign On Bonus** **_Clinical license as a registered nurse or respiratory therapist or master's in social work… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …+ Participate in interdisciplinary case rounds, quality improvement initiatives, and utilization review processes. + Support members during transitions of ... Position is On-Site The Behavioral Health Nurse - Managed Care is responsible for coordinating,...+ Experience in a managed care, case management, or utilization review setting + Strong understanding of… more
- MyFlorida (Port Charlotte, FL)
- SENIOR REGISTERED NURSE SUPV - 50009026 Date: Aug 25, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... No: 859588 Agency: Veterans Affairs Working Title: SENIOR REGISTERED NURSE SUPV - 50009026 Pay Plan: Career Service Position...Works under the direct supervision of the Executive Nursing Director (DON). Supervise and direct nursing personnel on an… more
- YesCare Corp (Tallahassee, FL)
- …measures including sentinel event review + Actively participant of the Utilization Review process and follow proper procedures. + Follows standard ... or nurse practitioners as required. + Notifies Regional Medical Director and Site Health Services Administrator of schedule changes. Assists in arrangement… more