- Elevance Health (Tampa, FL)
- …or case management experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or any combination of education ... 6pm EST and will include every weekend (Saturday and Sunday). The **Medical Management Nurse ** will be responsible for review of the most complex or challenging… more
- HCA Healthcare (Port Charlotte, FL)
- …and personal growth, we encourage you to apply for our Clinical Research Nurse opening. We promptly review all applications. Highly qualified candidates will ... We care like family! Jump-start your career as a Clinical Research Nurse today with HCA Florida Fawcett Hospital. **Benefits** HCA Florida Fawcett Hospital… more
- University of Miami (Miami, FL)
- …the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review this tip sheet ... Current Employees: If you are a current Staff , Faculty or Temporary employee at the University of Miami, please click here… 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 the office of the Chief Medical… more
- HCA Healthcare (Lake City, FL)
- …provision of nursing care in accordance with established policies/procedures and holds staff accountable for quality and clinical outcomes in support of facility ... participates in company-supported community/patient events and in-services. + Manages staff scheduling. Maintains staffing in accordance with patient care needs… more
- Fresenius Medical Center (St. Petersburg, FL)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- MTC (Graceville, FL)
- …variety of nursing skills all in one package!** The **Graceville Correctional** medical staff are dedicated to providing quality medical and dental services to men ... 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 operations. +… more
- Molina Healthcare (Jacksonville, FL)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care… more
- Molina Healthcare (Tampa, FL)
- …the Chief Medical Officer. + Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the ... for serving as the primary liaison between administration and medical staff . Assures the ongoing development and implementation of policies and procedures… more
- Molina Healthcare (Jacksonville, FL)
- …in preparation for national committee for quality assurance (NCQA) and utilization review accreditation commission (URAC) certifications. * Provides leadership ... the chief medical officer. * Evaluates authorization requests in timely support of nurse reviewers, reviews cases requiring concurrent review and manages the… more