- AdventHealth (Tampa, FL)
- …heart failure, cancer and other diseases. **The role you'll contribute:** The Utilization Management RN Supervisor reports directly to the Divisional Utilization ... performing the daily operations and supervision of team members in the Utilization Management department. Utilization Management team members will have defined… more
- Actalent (Sunrise, FL)
- Actalent is hiring a Utilization Management Nurse! Job Description The Utilization Management Nurse (UMN) collaborates closely with the interdisciplinary team to ... perform reviews of service authorization requests, ensuring the utilization of appropriate services. The UMN assists in complex cases, develops internal processes,… more
- CVS Health (Tallahassee, FL)
- …And we do it all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedule may include weekends, holidays and ... the state of Florida. **Applicant must reside in Florida** . As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document… more
- CVS Health (Tallahassee, FL)
- …AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Utilizes clinical experience and skills in a collaborative… more
- CVS Health (Tallahassee, FL)
- …opportunities to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal and external ... constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with productivity and… more
- Humana (Tallahassee, FL)
- …part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently… more
- Humana (Tallahassee, FL)
- …part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support the ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently… more
- Centene Corporation (Tallahassee, FL)
- …applied behavioral analytics (ABA). Additional Details: * Department: Behavioral Health Utilization Management * Business Unit: Corporate / Florida * Schedule: ... Analyzes BH member data to improve quality and appropriate utilization of services + Interacts with BH healthcare providers...to members and their families regrading ABA and BH utilization process + Provides feedback to leadership on opportunities… more
- Centene Corporation (Tallahassee, FL)
- …discharge planning + Analyzes BH member data to improve quality and appropriate utilization of services + Provides education to providers members and their families ... regrading BH utilization process + Interacts with BH healthcare providers as...in eastern or central time zone with experience in utilization management.** **Education/Experience:** Requires Graduate of an Accredited School… more
- CVS Health (Tallahassee, FL)
- …skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in clinically ... appropriate treatment, evidence-based care, and medical necessity criteria for appropriate utilization of services for child and adolescent members. + Consults and… more