- CVS Health (Tallahassee, FL)
- …years of acute experience as a Registered Nurse + 3+ years of Utilization Management experience + 3+ year(s) of Appeals experience in Utilization ... members. **Position Summary** The Associate Manager is responsible for oversight of Utilization Management staff. This position is responsible for the… 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
- Cognizant (Tallahassee, FL)
- …have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Actalent (Fort Lauderdale, FL)
- Actalent is Hiring a Behavioral Health Utilization Review Nurse Job Description We are seeking a dedicated Utilization Management Nurse (UMN) who ... Additional Skills & Qualifications + Current unrestricted Florida RN or LPN License. + Minimum of one year...+ Valid Florida Driver's License. + Knowledge of case management and utilization review concepts,… more
- Actalent (Sunrise, FL)
- Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing ... health. + Proficiency in clinical and utilization review processes. + Current unrestricted Florida RN ...+ Valid Florida Driver's License. + Knowledge of case management and utilization review concepts,… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …safe discharge coverage for all hospital units. + Participates in utilization management initiatives/opportunities for improvement through departmental committee ... assignments. Qualifications: + Registered Nurse , Licensed Practical Nurse ...Florida. + 3 years minimum experience in discharge planning, utilization management , or case management .… more
- Centers Plan for Healthy Living (Margate, FL)
- …applications for Full Time Registered Nurse without experience. The Utilization Management Clinical Reviewer works within a multidisciplinary team to ... in their home to improve their quality of life. Utilization Management Clinical Reviewer will...education, and preventative interventions are maintained. Qualifications: + Active RN license, entry level RN welcome +… more
- Select Medical (Oxford, FL)
- …Illness Recovery Hospital** **Director of Case Management ** **_Clinical license as a registered nurse or respiratory therapist or master's in social work and ... functions and professional growth of the department, including, but not limited to: Utilization Review (UR) and resource management , discharge planning,… more
- AdventHealth (Palm Coast, FL)
- …and experiences you'll need to succeed:** **Minimum qualifications** : + Associate's degree Nursing or RN Diploma degree. + Registered Nurse ( RN ) State ... satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily...+ Health-related Master's degree or MSN. + Prior Care Management / Utilization Management experience. + ACM/CCM… 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...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more