- Molina Healthcare (St. Petersburg, FL)
- … compliance . **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Licensed Registered Nurse ( RN ), Licensed Vocational Nurse ... an ongoing member case load for regular outreach and management . + As a Lead RN provide...run every workday and cases found non-compliant or missing compliance elements are remediated promptly + Case Management… more
- BayCare Health System (New Port Richey, FL)
- …care goals. + Knowledge of regulatory standards appropriate to position. **Requirements:** + RN ( Registered Nurse ) License + Driver's License, State of ... Career with BayCare HomeCare as a Home Care Supervisor, RN . At BayCare, we are proud to be one...required for their positions. + Assignment of patients and compliance with all regulatory bodies within the area of… more
- Molina Healthcare (St. Petersburg, FL)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more
- Molina Healthcare (Tampa, FL)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... Experience Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more
- Cleveland Clinic (Vero Beach, FL)
- …include: + Bachelor of science in nursing (BSN) + Current state licensure as a Registered Nurse ( RN ) + Basic Life Support (BLS) certification through the ... of the most respected healthcare organizations in the world. RN Case Managers work collaboratively with inter-professional teams across...or AHA) + 2 years of recent experience in utilization review, quality or care management +… more
- Community Health Systems (Naples, FL)
- …problem-solving skills for addressing unit challenges and emergencies. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or ... repayment plan ** Comprehensive benefits (Medical, Dental, Vision) **Job Summary** The RN Charge oversees the operations of a nursing unit during assigned shifts,… more
- Humana (Miramar, FL)
- …providers to ensure cohesive and evidence-based care. - Oversee and optimize utilization management processes within the organization. - Ensure resource ... put health first** The Home Health Wound Ostomy Care RN is a specialized nursing position primarily focused on...practices in wound care but also aim at controlling utilization to improve patient outcomes. The expertise of a… more
- AdventHealth (Daytona Beach, FL)
- …+ Associate or Diploma in Nursing from an accredited school + Current Florida Registered Nurse license + Current Basic Life Support (BLS) certification + Current ... 32117 **The role you'll contribute:** The ANM is a registered professional nurse who supports the ...resources to achieve quality performance, positive employee relations, and compliance with hospital guidelines. The ANM is skilled in… more
- AdventHealth (Tavares, FL)
- …+ Associate or Diploma in Nursing from an accredited school + Current Florida Registered Nurse license + Current Basic Life Support (BLS) certification + Current ... 32778 **The role you'll contribute:** The ANM is a registered professional nurse who supports the ...resources to achieve quality performance, positive employee relations, and compliance with hospital guidelines. The ANM is skilled in… more
- Molina Healthcare (Tampa, FL)
- …within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of previously denied cases ... Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. +… more