- 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 ... heart, each and every day. This position will be remote working from home anywhere in the US. **Schedule...Years of clinical experience. + 1+ Year of Utilization Review Management and/or Medical Management experience. +… more
- Actalent (Orlando, FL)
- Job Title: Clinical Review Nurse Job Description As a Clinical Review Nurse , you will perform concurrent reviews to assess members' overall health, ... review the type of care being delivered, evaluate medical necessity, and contribute to discharge planning following established...Texas nursing license. Work Environment This is a fully remote position with working hours from 10 am to… 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** + ... EST Hours; Shift times may vary based on business needs) **Location** : 100% Remote (US only) **Position Summary** American Health Holding, Inc. (AHH), a division of… more
- Prime Therapeutics (Tallahassee, FL)
- …and drives every decision we make. **Job Posting Title** Infusion Referral Nurse - REMOTE **Job Description** Under supervision, is responsible for performing ... Nursing + Bachelors - Nursing + RN - Registered Nurse , State and/or Compact State Licensure - Care Mgmt...in managed care, specialty drugs, care management and utilization review . + Meets Credentialing criteria. + At minimum must… more
- Datavant (Tallahassee, FL)
- …+ 3+ years of CDI experience + 3+ years of clinical experience in an academic medical center + Registered Nurse license, Bachelor's degree in Nursing + CCDS or ... you will play a pivotal role in elevating the impact of our medical record documentation. You will conduct daily evaluations and engage in direct communication… more
- Actalent (Orlando, FL)
- Job Title: Clinical Review NurseJob Description: The Review Nurse will be responsible for reviewing approximately 20 cases a day to assess medical ... decisions and gather additional information about the member's condition. Responsibilities: + Review approximately 20 cases a day for medical necessity. +… more
- CVS Health (Tallahassee, FL)
- …do it all with heart, each and every day. **Position Summary** **This is a remote work from home role anywhere in the US with virtual training.** **Shift schedule is ... of residence.** American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS...**Required Qualifications** + 5+ years' experience as a Registered Nurse (RN) with at least 1 year of experience… more
- University of Miami (Medley, FL)
- …. The Telehealth Nursing Department has an exciting opportunity for a Licensed Practical Nurse (LPN). This position is not remote . The LPN: + CORE JOB ... FUNCTIONS + Collects patient assessment data and notifies appropriate nurse of actual or potential problems and needs on an ongoing basis. + Records patient… more
- AdventHealth (Altamonte Springs, FL)
- … Remote **The role you'll contribute:** A Workers Comp Support Registered Nurse is responsible for providing telephonic medical case management for Workers ... written consent required, and NC: must be registered rehab nurse with NCIC) + Reports directly to the WC... treatment plan based on data collected through telephonic medical interview, assessment and review of … 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