- Actalent (Fort Lauderdale, FL)
- Actalent is Hiring a Behavioral Health Utilization Review Nurse Job Description We are seeking a dedicated Utilization Management Nurse (UMN) who will work ... internal process development, and provide education to the team on utilization review -related issues. Responsibilities + Review prior authorization requests for… more
- Elevance Health (Hialeah, FL)
- **HEDIS Medical Records Review Project Nurse ** **Location: Must be located within 50 miles of an Elevance Health PulsePoint office in the state of Florida.** ... is granted as required by law._ The **HEDIS Medical Records Review Project Nurse ** is responsible for HEDIS medical record identification and abstraction… more
- Actalent (Sunrise, FL)
- Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing requests for ... with the interdisciplinary team, the UMN handles tasks related to utilization review across various specialties, medical treatments, and services. The role involves… more
- Molina Healthcare (Tampa, FL)
- …set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing clinical knowledge and experience, ... responsible for review of documentation to ensure medical necessity and appropriate...quality of care issues. + Assists with Complex Claim review including DRG Validation, Itemized Bill Review ,… more
- Lincoln Financial (Tallahassee, FL)
- …proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills **Application ... We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position...in a career at Lincoln, we encourage you to review our current openings and apply on our website.… more
- Veterans Affairs, Veterans Health Administration (Winter Park, FL)
- …and adjust plans for care delivery Completed work should only need very limited review by a registered nurse (RN) or Provider for appropriateness and conformity ... Lake Baldwin VA Clinic located in Winter Park, FL is looking for a Licensed Practical Nurse at the GS-7 level to work in the Surgical Specialty clinic within in the… more
- ChenMed (Largo, FL)
- …visits. Once a patient has completed their episode of care management the register nurse (RN) will review patient chart for discharge and conduct final discharge ... The Intensive Community Care Manager (ICCM) is a Registered Nurse (RN) who works with our highest complexity patients,...patient needs and services available in the community or review of their benefits. + Completes individual plan of… more
- HCA Healthcare (Orange Park, FL)
- …personal growth, we encourage you to apply for our PRN Endoscopy/GI Registered Nurse opening. We review all applications. Qualified candidates will be contacted ... have the career opportunities as a PRN Endoscopy/GI Registered Nurse you want with your current employer? We have...want to work as a PRN Endoscopy GI Registered Nurse where your passion for creating positive patient interactions… more
- Elevance Health (Tampa, FL)
- …employment, unless an accommodation is granted as required by law. The **Medical Management Nurse ** is responsible for review of the most complex or challenging ... **Medical Management Nurse ** **Hours: Candidates will work 8a-5pm PST with...and requires a minimum of 2 years clinical, utilization review , or case management experience; or any combination of… more
- HCA Healthcare (Jacksonville, FL)
- …and personal growth, we encourage you to apply for our PRN Operating Room Nurse opening. We review all applications. Qualified candidates will be contacted for ... have the career opportunities as a PRN Operating Room Nurse you want with your current employer? We have...you want to work as a(an) PRN Operating Room Nurse where your passion for creating positive patient interactions… more