- AdventHealth (Riverview, FL)
- …Qualifications **The expertise and experiences you'll need to succeed:** Associates Degree Nursing or RN Diploma degree Registered Nurse ( RN ) State ... orthopedic and womens care. **The role you'll contribute:** The RN Care Manager in collaboration with the...physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge… more
- CenterWell (Tallahassee, FL)
- …community and help us put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part...on excellent service to others. **Required Qualifications** + Active RN license + Possession of or ability to obtain… more
- CenterWell (Tallahassee, FL)
- …and the healthcare industry as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part...skills to make an impact** **Role Essentials** + Active RN license + Possession of or ability to obtain… more
- HCA Healthcare (Gainesville, FL)
- …opportunity compelling, we encourage you to apply for our RN Case Manager opening. We promptly review all applications. Highly qualified candidates will be ... benefits may vary by location._** We are seeking an RN Case Manager for our team to...is preferred + Certification in Case Management, Nursing or Utilization Review is preferred HCA Florida North… more
- Molina Healthcare (St. Petersburg, FL)
- …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
- Adecco US, Inc. (Altamonte Springs, FL)
- …an acute clinical care setting or equivalent. . Previous care management, utilization review or discharge planning experience. . RN License in FL . BLS ... Adecco Healthcare & Life Sciences is looking for an ** RN Case Manager ** for our client in...the cost consequences resulting from Care Management decisions through utilization of reports and systems such as Health Plan… more
- HCA Healthcare (Fort Walton Beach, FL)
- …is preferred + BSN is preferred + Certification in Case Management, Nursing or Utilization Review is preferred HCA Florida Fort Walton-Destin Hospital is a ... join an organization that invests in you as a(an) RN Case Manager Evenings? At HCA Florida...patients, families, hospital staff, and outside agencies + Performs utilization management reviews and communicates information to third party… more
- Molina Healthcare (Tampa, FL)
- **JOB DESCRIPTION** For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state they reside This position will support ... Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support,… more
- BayCare Health System (Lakeland, FL)
- …care goals. + Knowledge of regulatory standards appropriate to position. **Requirements:** + RN ( Registered Nurse ) License + Driver's License, State of ... Career with BayCare HomeCare as a Home Care Supervisor, RN . At BayCare, we are proud to be one...Case Manager on initial Plan of Care review with a focus on quality, utilization … more
- NHS Management, LLC (West Melbourne, FL)
- …of subordinate nurses engaged in quality assurance, infection control, and utilization review activities. + Receives physicians' instructions regarding resident ... LOW cost gold medical plan! We are in search of a qualified RN Unit Manager : + Assists in maintaining resident care standards by supervising and directing… more