- HCA Healthcare (Gainesville, FL)
- …physical, psycho-social, financial). 1. Participates in IDT rounds, 1. Conducts utilization review , evaluates clinical information, and communicates findings to ... on a timely basis in accordance with the NFRMC Utilization Review Plan and managed care contractual...(list required and preferred separately) Currently licensed as a registered professional nurse in the state(s) of… more
- HCA Healthcare (Fort Lauderdale, FL)
- …+ Lead centralized case management function, including Clinical Case Management, Utilization Review Services, and Clinical Documentation Improvement. Works ... + 10+ years overall case management experience required + Currently licensed as a Registered Nurse in the state(s) of practice according to law and regulation… more
- Elevance Health (Tampa, FL)
- **Telephonic Nurse Case Manager II** **Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person ... the assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope… more
- Elevance Health (Tampa, FL)
- …following standard procedures that do not require the training or skill of a registered nurse . **How you will make an impact** Primary duties may include ... a minimum of 2 years of clinical experience and/or utilization review experience. + Current active, valid...experience. + Current active, valid and unrestricted LPN/LVN or RN license and/or certification to practice as a health… more
- Sharecare (Tallahassee, FL)
- …to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they ... utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification… more
- MyFlorida (Largo, FL)
- …leave. Paid holidays and personal day. Retirement package. REQUIREMENTS + Unencumbered Florida Registered Nurse License. + Must be willing and able to travel ... (4) or more years of experience as a Licensed Registered Nurse in Long-Term Care facility. +...facility. + Experience as a Director of Nursing or Nurse Manager in a Skilled Nursing Facility,… more
- CVS Health (Tallahassee, FL)
- …clinical judgement as well as knowledge of internal systems. **Required Qualifications** - Registered Nurse ( RN ) with current unrestricted compact license ... Quality of Care (PQOC) nurse investigator team manager . This position is responsible for the review...- Experience working Grievance cases - Case Management or Utilization Management experience - Managed care experience - Medicaid… more
- HCA Healthcare (Gainesville, FL)
- …recognizes physicians as important customers. What qualifications you will need: + State Registered Radiologic Technician, or Registered Nurse + Associate ... Cardiac Cath Lab with HCA Florida North Florida Hospital, you can be a manager in an organization that is devoted to giving! **Benefits** HCA Florida North Florida… more
- HCA Healthcare (Sun City Center, FL)
- …required in Nursing or Healthcare related field . Current Florida licensure as a Registered Nurse preferred _**If serving as facility's primary Risk Manager , ... Quality) OR CHCQM (Diplomate in American Board of Quality Assurance and Utilization Review Physicians) _Individuals without CPHQ or ABQUARP will be granted a 12… more
- CenterWell (Daytona Beach, FL)
- …the strategic intent + Overseeing other clinicians which includes Physicians, Advanced Registered Nurse Practitioners (ARNP), and Physicians Assistants (PA) + ... inquiries, requests, and complaints from patients + Ongoing chart review / audit of clinical staff to ensure quality...+ Identifying trends and areas of opportunity in pharmacy utilization (pharmacy management) to impact Part D per Member… more