- CVS Health (Tallahassee, FL)
- …in a collaborative process to implement, coordinate, monitor and evaluate medical review cases. Applies the appropriate clinical criteria/guideline and plan language ... or policy specifics to render a medical determination to the client. Applies critical thinking, evidenced...Director referral as needed. Assists management with training new nurse reviewers/business partners or vendors to include initial and… more
- HCA Healthcare (Brooksville, FL)
- **Description** **Introduction** Do you have the career opportunities as a(an) RN Registered Nurse Lactation Consultant PRN you want in your current role? We ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...**Job Summary and Qualifications** We are seeking a Lactation Consultant Registered Nurse for our Obstetrics Unit.… more
- NHS Management, LLC (Tallahassee, FL)
- …the successes they experience along the way. We are in search of a qualified Regional Nurse Consultant : The Regional Nurse Consultant will be responsible ... opportunities advancement! General Responsibilities To consult the assigned facilities on nursing functions of the facility in accordance with current federal, state… more
- CVS Health (Tallahassee, FL)
- …high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team. **Key Responsibilities** + ... Holding, Inc. (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective care… more
- CVS Health (Tallahassee, FL)
- …of time, talking on the telephone, and typing on the computer. The UM Nurse Consultant utilizes clinical skills to coordinate, document and communicate all ... thinking and knowledge in clinically appropriate treatment, evidence-based care and medical necessity criteria for appropriate utilization of services. + Utilizes… more
- CVS Health (Tallahassee, FL)
- …and work schedule may include weekends, holidays, and evening hours._ **UM Nurse Consultant ** Fully Remote- WFH **Position Summary** + Utilizes clinical ... of Medicare/Medicaid + Managed care experience **Education** + Associates Degree in Nursing required + BSN preferred **Anticipated Weekly Hours** 40 **Time Type**… more
- IQVIA (Pensacola, FL)
- The **Part Time Clinical Consultant (PTCC)** role is an exciting opportunity to join IQVIA. IQVIA/MedTech takes the approach to helping customers drive healthcare ... understanding of their applications. + Improve patient outcomes by delivering ventricular medical device education in a variety of settings, including but not… more
- CVS Health (Tallahassee, FL)
- …of Florida. **Applicant must reside in Florida** . As a Utilization Management Nurse Consultant , you will utilize clinical skills to coordinate, document and ... thinking and knowledge in clinically appropriate treatment, evidence-based care and medical necessity criteria for appropriate utilization of services. - Consults… more
- CVS Health (Tallahassee, FL)
- …training / 8:30am-5pm EST, Monday-Friday.** American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health. Founded in ... Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support cost-effective quality care for members.… more
- CVS Health (Tallahassee, FL)
- …with clinician/MD support as required. Considers all documentation provided including medical records and system documentation to evaluate post-service claims for ... required - 2+ years of experience as a Registered Nurse - Must have active current and unrestricted RN...our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company… more