- CVS Health (Tallahassee, FL)
- …skills in a collaborative process to implement, coordinate, monitor and evaluate medical review cases. + Applies the appropriate clinical criteria/guideline and ... quality and metric expectations. **Required Qualifications** + Registered Nurse (RN) - active license. + 3+ Years of...Years of clinical experience. + 1+ Year of Utilization Review Management and/or Medical Management experience. +… more
- Actalent (Sunrise, FL)
- …staff to direct utilization and capture data effectively. Responsibilities + Review prior authorization requests for medical necessity and appropriateness, ... Utilization Management Nurse !Job Description The Utilization Management Nurse ...standardized Review Criteria. + Coordinate with the Medical Director/Physicians for requests outside standard Review … more
- Humana (Tallahassee, FL)
- …caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and ... communication of medical services and/or... services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require… more
- AdventHealth (Ocala, FL)
- …The Coordinator Professional Practice Evaluation is responsible for facilitating the medical staff Peer Review , Ongoing Professional Practice Evaluation (OPPE) ... This includes the analysis of events that require peer review and the examination of medical records...for managing and maintaining the confidentiality of the peer review process, quality records and performance improvement… more
- Molina Healthcare (Tampa, FL)
- …HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of ... within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests additional information from members or providers in… more
- University of Miami (Miami, FL)
- … Medical Training Lab at the Gordon Center is currently seeking a full time Nurse Educator - Medical Simulation and Education Lab to work in Miami, FL. The ... of Miami Gordon Center, as well as our community clinical partners, to ensure high quality clinical outcomes. The Simulation Nurse Educator is part of the Gordon… more
- AdventHealth (Altamonte Springs, FL)
- **Registered Nurse Quality Improvement** **AdventHealth** **Ventures** **All the benefits and perks you need for you and your family:** + Benefits from Day One + ... 900 HOPE WAY, Altamonte Springs, 32714 **The role you'll contribute:** The Quality Improvement RN provides clinical leadership and support for the specialty… more
- HCA Healthcare (Hudson, FL)
- …to you, we encourage you to apply for our Registered Nurse Medical Surgical opening. Our team will promptly review your application. Highly qualified ... in their positions. Join our Team as a(an) Registered Nurse Medical Surgical and access programs to...to learn! **Job Summary and Qualifications** As a Registered Nurse , you will be responsible for delivering high- quality… more
- HCA Healthcare (Gainesville, FL)
- …and continue to learn! **Job Summary and Qualifications** As a Registered Nurse , you will be responsible for delivering high- quality , patient-centered care ... in their positions. Join our Team as a(an) Registered Nurse Post-Op Renal Vascular and access programs to assist...colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no… more
- HCA Healthcare (Englewood, FL)
- …set us apart from any other healthcare provider. We are seeking a(an) Registered Nurse Medical Surgical Unit to join our healthcare family. **Benefits** HCA ... passion for patient care. Apply today for our Registered Nurse Medical Surgical Unit opportunity. **Job Summary...provide clinical expertise to ensure all patients receive high quality , efficient care in a medical surgical… more
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