- HCA Healthcare (Tallahassee, FL)
- …active FL RN licenserequiredwithin90 days of hire** + **Advanced Practice Registered Nurse license is acceptable for position if current and compliant** ... medical necessity, admission status, level of care, and resource management . The RN CM Care Coordinator will...+ **Certification in Case Management , Nursing, or Utilization Review ,… more
- HCA Healthcare (Tallahassee, FL)
- …is acceptable for position if current and compliant** + **Certification in Case Management , Nursing, or Utilization Review , preferred** + **Three years ... and assess observation patients for appropriateness in observation status + Performs utilization management reviews and communicates information to third party… more
- MTC (Graceville, FL)
- …medical team who are dedicated to improving people's lives. We are seeking an **On-Call Registered Nurse ( RN )** to join our team. **Primary duties:** + ... forms as appropriate. + Practice basic cost containment and utilization management for inmate care and facility...HIPAA rules. + Accurately and promptly chart medical care. Review medical files to determine all provided services are… more
- Molina Healthcare (Miami, FL)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The RN Clinical Appeals Nurse provides support... licensure, Diagnosis-Related Group (DRG) experience, 2 years of Utilization Review and/or Medical Claims Review… more
- MTC (Graceville, FL)
- …record or other forms as appropriate. + Practice basic cost containment and utilization management for inmate care and facility operations. + Maintain absolute ... difference every day! Are you a dedicated and skilled RN looking for a meaningful opportunity to provide exceptional...HIPAA rules. + Accurately and promptly chart medical care. Review medical files to determine all provided services are… more
- Elevance Health (Tampa, FL)
- …center The **Manager Behavioral Health Services** is responsible for Behavioral Health Utilization Management (BH UM), or Behavioral Health Case Management ... cost of care initiatives. + May attend meetings to review UM and/or CM process and discusses facility issues....and/or outpatient psychiatric and chemical dependency treatment and prior utilization management experience; or any combination of… more
- Molina Healthcare (FL)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... Experience Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines. MULTI… more
- HCA Healthcare (Sanford, FL)
- …in Case Management is preferred + BSN is preferred + Certification in Case Management , Nursing or Utilization Review is preferred HCA Florida Lake Monroe ... Summary and Qualifications** We are seeking a dynamic Case Management RN to join our team. We...patients, families, hospital staff, and outside agencies + Performs utilization management reviews and communicates information to… more
- HCA Healthcare (Kissimmee, FL)
- …monitor and improve the patient flow program effectiveness as it relates to utilization review , resource management , and discharge planning and care ... leader to physicians and employees as it relates to utilization review , resource management , patient...obtained within 30 days of employment start date + ( RN ) Registered Nurse + Associate… more
- Ascension Health (Pensacola, FL)
- …two (2) years of proven leadership or management experience, preferably overseeing Case Management or Utilization Review teams in an Acute Care setting. ... **Details** + **Department:** Case Management + **Schedule:** Full time Day Shift +... department. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Florida Board… more