- BayCare Health System (Tampa, FL)
- …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Management Assistant responsibilities include:** + Participating on the ... Utilization Management Team (UMT), serving as a Utilization Management liaison with managed care organizations, collaborating with Medical Staff, Business Office,… more
- BayCare Health System (Largo, FL)
- …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Coordinator(Homecare) responsibilities include:** + Coordinates utilization ... and admission documentation completeness. + Communicates to and educates staff regarding utilization and paperwork issues. + One UR will be responsible for a… more
- AdventHealth (Tampa, FL)
- …cancer and other diseases. **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse (RN) is to use clinical expertise by ... of admission; and when warranted by length of stay, utilization review plan, and/or best practice guidelines, on a...of critical care nursing experience preferred. 1 years of utilization management experience preferred. This facility is an equal… more
- AdventHealth (Tampa, FL)
- …diseases. **The ro** **le you'll contribute:** The role of the Emergency Department Utilization Management (UM) Registered Nurse (RN) is to use clinical expertise by ... designated leader for additional review as determined by department standards. The Utilization Management Nurse is accountable for a designated patient caseload and… more
- AdventHealth (Tampa, FL)
- …diseases. **The role you'll contribute:** The role of the Emergency Department Utilization Management (UM) Registered Nurse (RN) is to use clinical expertise by ... designated leader for additional review as determined by department standards. The Utilization Management Nurse is accountable for a designated patient caseload and… more
- Molina Healthcare (Tampa, FL)
- **Knowledge/Skills/Abilities** + Perform research and analysis of complex healthcare utilization and performance date, claims data, pharmacy data, and lab data ... regarding utilization and cost containment information. + Evaluate, write, and...cost containment information. + Evaluate, write, and present healthcare utilization and cost containment reports and makes recommendations based… more
- Monte Nido (Miami, FL)
- …while providing the opportunity for people to realize their healthy selves. ** Utilization Review Clinician** **Monte Nido** **Remote - EST or CST hours** **Monte ... to provide comprehensive care within an intimate home setting. The Utilization Review **Clinician** is responsible for conducting daily administrative and… more
- CenterWell (Tallahassee, FL)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare +… more
- Actalent (Orlando, FL)
- …validate the necessity and setting of care. Essential Skills + Proficiency in utilization management and utilization review + Experience with Interqual and ... Medicare + Expertise in medical, acute care, concurrent review, and prior authorization + Knowledge of managed care and patient care Additional Skills & Qualifications + 2-4 years of hospital experience in areas such as ICU, ER, Med-Surge, PACU, etc. + Strong… more
- CenterWell (Tallahassee, FL)
- …Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare/Medicaid… more