- Community Health Systems (Naples, FL)
- …partners with providers and staff to drive compliance with utilization policies. The UR Nurse also contributes to the development of departmental procedures, ... Join us as a **Registered Nurse (RN) - Utilization Review position** at Physicians...internal departments to promote process improvement and compliance with UR standards and KPIs. + Serves as a resource… more
- Evolent (Tallahassee, FL)
- …Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed ... medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care across the continuum… more
- Datavant (Tallahassee, FL)
- …clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and ... by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in...experience + 2 years Health Plan or Acute Care UR /CM + Preferred Experience: 5 years acute care or… more
- Select Medical (Gainesville, FL)
- …Management** **Full Time: Monday - Friday 8-5pm** **_Clinical license as a registered nurse or respiratory therapist or master's in social work and minimum three (3) ... growth of the department, including, but not limited to: Utilization Review ( UR ) and resource management, discharge planning, treatment plan management and financial… more
- Select Medical (Lake Worth, FL)
- …of Case Management** **$10,000 Sign On Bonus** **_Clinical license as a registered nurse or respiratory therapist or master's in social work and minimum three (3) ... growth of the department, including, but not limited to: Utilization Review ( UR ) and resource management, discharge planning, treatment plan management and financial… more
- Select Medical (Miami, FL)
- …As Well** _Requires a current licensure in a clinical discipline either as a Nurse or a Respiratory Therapist OR Social Work SW/MSW (potential license per state ... compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with Quality Management to assure all licensure and… more
- Select Medical (Lake Worth, FL)
- …8-5pm** _Requires a current licensure in a clinical discipline either as a Nurse (RN/LPN/LVN) or a Respiratory Therapist (RT) OR Medical Social Work (license per ... compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with Quality Management to assure all licensure and… more
- HCA Healthcare (Panama City, FL)
- …HCA Florida Gulf Coast Hospital, our nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want to create your own personal career ... and transmits system issues impacting patient care to Case Management Director/CFO/ UR committee, as appropriate + Ensures the appropriate status is declared… more
- University of Miami (Coral Gables, FL)
- …to ensure delivery prior to clinic visits. + Communicates to the appropriate nurse coordinator if difficult or unable to obtain pertinent records. + Prepares ... communication with CTU and relay information to MD/NP + Assist in communication with UR and Pathology + Ensure proper communication between MD, NP, RN, MA regarding… more