- CVS Health (Tallahassee, FL)
- …day working with providers to secure additional information for prior authorization review . + This candidate will utilize clinical skills to coordinate, document and ... of varied UM (utilization management) experience within an **outpatient** setting, concurrent review or prior authorization. + 5 years of a variety clinical… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- Position is On-Site The Behavioral Health Nurse - Managed Care is responsible for coordinating, monitoring, and delivering behavioral health services within a ... in interdisciplinary case rounds, quality improvement initiatives, and utilization review processes. + Support members during transitions of care, including… more
- Molina Healthcare (Tampa, FL)
- …outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases ... the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, or other specific program… more
- AdventHealth (Altamonte Springs, 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 ... needed. + Actively participates in daily Multidisciplinary Rounds to review progression of care and discharge plan for all...State of Florida or multistate license as a Registered Nurse + 2 years of medical/ hospital nursing experience… more
- ChenMed (Tamarac, FL)
- …and explain primary care provider role. Facilitate patient/family conferences to review treatment goals, optimize resource utilization, provide family education and ... quality of health care. + Applies skills in peer review to promote a culture of excellence. + Anticipates...or similar advanced degree in Nursing required + Current Nurse Practitioner Certification in the State of practice required… more
- University of Miami (Miami, FL)
- …or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . CORE JOB ... This position is not remote. The Advanced Practice Registered Nurse (APRN) d elivers medical care to a wide...+ Actively participates in quality assurance programs and peer review activities. + Responsible for helping physicians in the… more
- University of Miami (Miami, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Work ... discharge and readmission risk. + Evaluates the plan of care regularly by chart review and patient interviews, as well as collaborates with the medical team to… more
- University of Miami (Miami, FL)
- …or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Sign on ... have been performed and received for the physician to review the findings. 4. Develops a system that elevates...any abnormal results (non - critical values) to the nurse who in turn will contact the physician accordingly… more
- University of Miami (Deerfield Beach, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . We're Hiring ... JOB SUMMARY Deliver compassionate, expert oncology care with us. The Registered Nurse 2 - Specialty delivers patient-family centered care in a culturally competent… more
- Wellpath (Florida City, FL)
- …one patient at a time. **How you make a difference** As a **Registered Nurse (RN)** , you'll play a pivotal role in delivering compassionate, high-quality care to ... Supervise and delegate tasks to licensed practical nurses and team members, review nursing care documentation, and ensure proper administration of medications and… more