- Actalent (Orlando, FL)
- …to validate the necessity and setting of care. Essential Skills + Proficiency in utilization management and utilization review + Experience with Interqual ... Job Title: Clinical Review Nurse Job Description As a Clinical ...Texas nursing license. Work Environment This is a fully remote position with working hours from 10 am to… more
- Centene Corporation (Tallahassee, FL)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... a fresh perspective on workplace flexibility. **Position Purpose:** Performs a clinical review and assesses care related to mental health and substance abuse.… more
- Centene Corporation (Tallahassee, FL)
- …assess ABA Treatment Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with providers and healthcare ... benefits including a fresh perspective on workplace flexibility. NOTE: This is a fully remote role. Preference will be given to applicants who reside in Florida, who… more
- Monte Nido (Miami, FL)
- …save lives while providing the opportunity for people to realize their healthy selves. ** Utilization Review Clinician** **Monte Nido** ** Remote - EST or CST ... provide comprehensive care within an intimate home setting. The Utilization Review **Clinician** is responsible for conducting...billing and account follow-up. This is a Full Time remote position supporting our virtual programs on East and… more
- CVS Health (Tallahassee, FL)
- …of varied UM ( utilization management) experience within an inpatient, concurrent review or prior authorization. + Remote work experience. **Education** + ... with heart, each and every day. **Position Summary** **100% remote position from anywhere in the US** **Work hours:...utilization management) experience within an **outpatient** setting, concurrent review or prior authorization. + 5 years of a… more
- CenterWell (Tallahassee, FL)
- …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work… more
- CenterWell (Tallahassee, FL)
- …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to… more
- BAYADA Home Health Care (Orlando, FL)
- …should be available Monday-Friday from 8:30am-5:00pm. _Medicare, Coder, OASIS Review , Utilization Review , Quality Assurance, Remote , Home Health Coding_ ... Home Health Care is hiring a full time OASIS Review and Coding Manager. The OASIS and Coding ...also available). **BAYADA Perks:** + This role is **fully remote ,** candidates may be based anywhere in the US… more
- BAYADA Home Health Care (Orlando, FL)
- …with an industry leader. Apply now for immediate consideration. OASIS Review , Utilization Review , Quality Assurance, Remote , Home Health Coding, Coder, ... immediate opening for a **Full Time,** OASIS and Coding Review Manager with OASIS and Coding certification to work...they need. **BAYADA Perks:** + This is a fully remote , permanent salaried position. + Base Salary: **$74,000** /… more
- Evolent (Tallahassee, FL)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to make a… more