- AdventHealth (Altamonte Springs, FL)
- …role you will contribute:** The role of the Utilization Management (UM) Registered Nurse ( RN ) is to use clinical expertise by analyzing patient ... including concurrent payer communications to resolve status disputes. The Utilization Management Nurse is accountable.... Current and valid license to practice as a Registered Nurse (ADN or BSN) required. .… more
- Sharecare (Tallahassee, FL)
- …cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible for early identification of those ... according to the disease management program intervention guidelines. A Clinical Registered Nurse is supervised by an Operations Manager (OM). All Sharecare… more
- ChenMed (Miami, FL)
- …We're rapidly expanding and we need great people to join our team. The Registered Nurse 1, Care Line, is responsible for providing telephonic triage directional ... and assessments within license and as possible given technology and medium. The registered nurse collaborates with primary caregivers and others on the… more
- ChenMed (North Miami, FL)
- …expanding and we need great people to join our team. The Part Time Registered Nurse , Virtual Care, is responsible for providing telephonic emergency triage and ... client counseling, patient advocacy, health education and referral and resource management to ChenMed patients and their families. Providing on-call coverage, the… more
- ChenMed (Miami, FL)
- …rapidly expanding and we need great people to join our team. The Registered Nurse , Telehealth is responsible for providing telephonic triage directional patient ... issues, client counseling, patient advocacy, health education and referral and resource management to ChenMed patients and their families. The incumbent in this role… more
- CVS Health (Tallahassee, FL)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... reviews **Required Qualifications** - 5+ years' experience as a Registered Nurse with at least 1 year...using a keyboard **Preferred Qualifications** - 1+ years' Case Management experience or discharge planning, nurse navigator… more
- Humana (Tallahassee, FL)
- …of our caring community and help us put health first** The Senior Compliance Nurse reviews utilization management activities and documentation to ensure ... your skills to make an impact** **Required Qualifications:** + Registered Nurse with a Bachelor's degree in...action + Minimum two, (2) years of experience in utilization management + Intermediate proficiency using Microsoft… more
- AdventHealth (Altamonte Springs, FL)
- …expertise and experiences you'll need to succeed:** . Bachelor's . 1 Related Experience . Registered Nurse ( RN ) . Extensive understanding of CPT, HCPCS, ICD, ... rebilling. + Collaborates with pre-access, patient financial services, revenue integrity, utilization management and clinical department staff to obtain further… more
- CVS Health (Tallahassee, FL)
- …all with heart, each and every day. **Position Summary** This is a fulltime remote Utilization Review opportunity. Working hours are four 10hr days **including ... external constituents in the coordination and administration of the utilization /benefit management function. + UMNC meets set...by their Leader. **Required Qualifications** + Active and unrestricted Registered Nurse in state of residence +… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the… more