- CVS Health (Tallahassee, FL)
- …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... is URAC accredited in Case Management , Disease Management and Utilization Management . AHH...in a hospital setting. + A Registered Nurse that holds an active, unrestricted… more
- Humana (Hallandale Beach, FL)
- …+ Bachelor's degree in social work or behavioral health-related field + Active licensed Registered Nurse , RN in the state of Florida without disciplinary ... ensure interaction between the company and members are optimized. The Telephonic Behavioral Health Care Manager Internship provides transitioning service members… more
- ChenMed (Miami, FL)
- …providers. We're rapidly expanding and we need great people to join our team. The Registered Nurse 1, Care Line, is responsible for providing telephonic ... and assessments within license and as possible given technology and medium. The registered nurse collaborates with primary caregivers and others on the… more
- ChenMed (Jacksonville, FL)
- …and we need great people to join our team. The Registered Nurse , Telehealth is responsible for providing telephonic triage directional patient care advice ... 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)
- …appropriate member care. . Attends and participates in case rounds, including utilization management rounds for behavioral health and physical health to ... status which has resulted in an inpatient admission. The Transition of Care (TOC) RN ensures the member experiences a seamless transition to their next care setting.… 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 ... 48 hours of receipt and meet the criteria._** The ** Telephonic Nurse Case Manager II** is responsible...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- Trinity Health (Fort Lauderdale, FL)
- …acute hospital clinical experience is required.** Recent experience in case management , utilization review, discharge planning, ongoing monitoring and evaluation ... **Employment Type:** Full time **Shift:** **Description:** Functions as Primary Nurse Reviewer for Observation services. * Maintains a working relationship with… more
- ERP International (Macdill AFB, FL)
- **Overview** ERP International is seeking ** Registered ** ** Nurse ( RN )** for Full-Time positions in **Case Management ** at MacDill AFB, FL. Apply online ... algorithms, CM software, and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case management with… more
- Sharecare (Tallahassee, FL)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the… more
- Elevance Health (Lakeland, FL)
- …within the scope of licensure including, for example, assisting the responsible RN with telephonic or face-to-face assessments for the identification, ... Coordinator - Clinician** works under the direction/supervision of an RN , with overall responsibility for the member's case, as...evaluation, coordination and management of member's needs, including physical health, behavioral health,… more