- Molina Healthcare (Orlando, FL)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. Required Qualifications...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Jacksonville, FL)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
- Molina Healthcare (St. Petersburg, FL)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. Required Qualifications * At least 2… more
- Molina Healthcare (Miami, FL)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. Required Qualifications * At least 2… more
- Community Health Systems (Naples, FL)
- …coordinating patient care activities under the supervision of a Registered Nurse or physician. This role involves reviewing medical records for ... Program ** Student Loan repayment plan ** Comprehensive benefits ( Medical , Dental, Vision) **Job Summary** The Care Manager -...cases as needed to the Physician Advisor or Utilization Management ( UM ) committee. + Identifies avoidable hospital… more
- Datavant (Tallahassee, FL)
- …job function as delegated by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and ... expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well...Word, Excel, Outlook, experience working in a health plan medical management documentation system a plus. Minimum… more
- University of Miami (Miami, FL)
- … Medical Training Lab at the Gordon Center is currently seeking a full time Nurse Educator - Medical Simulation and Education Lab to work in Miami, FL. The ... Nurse Educator provides clinical education to nursing and patient..., and critical thinking skills development. + Collaborates with medical providers, patient care staff, and unit management… more
- Evolent (Tallahassee, FL)
- …mission. Stay for the culture. **What You'll Be Doing:** The Nurse Practitioner/Physician Assistant (ARNP/NP/PA) Cardiology is responsible for support and assistance ... for all cardiology administrative and clinical utilization management and quality improvement functions under the auspices of...under the auspices of the office of the Chief Medical Officer. **ESSENTIAL DUTIES AND RESPONSIBILITIES** : include the… more
- Elevance Health (FL)
- …treatment health benefits through telephonic or written review. The BH Care Manager ( UM ) job progression is primarily a provider-facing role although it does involve ... behavioral healthcare in a cost-effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to...equivalent background. + Current active unrestricted license such as RN LCSW LMSW LMHC or (as allowed by applicable… more
- Highmark Health (Tallahassee, FL)
- …:** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides oversight over a ... in health status/severity and clinical needs; and assesses health management needs of the assigned member panel and utilizing...in a clinical setting **Preferred** + 5 years in UM /CM/QA/Managed Care + 1 year in advanced training and… more