- Actalent (Sunrise, FL)
- Actalent is hiring a Utilization Management Nurse ! Job Description The Utilization Management Nurse (UMN) collaborates closely with the ... activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management + InterQual + Milliman Commercial Guidelines… more
- CVS Health (Tallahassee, FL)
- …anywhere in the state of Florida. **Applicant must reside in Florida** . As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... 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… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- AdventHealth (Tampa, FL)
- …failure, cancer and other diseases. **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse (RN) is to use clinical ... order or a status conflict is indicated, the UM nurse is responsible for escalation to the Physician Advisor...of critical care nursing experience preferred. 1 years of utilization management experience preferred. This facility is… more
- AdventHealth (Tampa, FL)
- …or designated leader for additional review as determined by department standards. The Utilization Management Nurse is accountable for a designated patient ... **The ro** **le you'll contribute:** The role of the Emergency Department Utilization Management (UM) Registered Nurse (RN) is to use clinical expertise… more
- AdventHealth (Tampa, FL)
- …or designated leader for additional review as determined by department standards. The Utilization Management Nurse is accountable for a designated patient ... diseases. **The role you'll contribute:** The role of the Emergency Department Utilization Management (UM) Registered Nurse (RN) is to use clinical expertise… more
- CVS Health (Tallahassee, FL)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... from work._ **Required Qualifications** + 1 year of varied UM ( utilization management ) experience within an **outpatient** setting, concurrent review… more
- CVS Health (Tallahassee, FL)
- …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area - Managed Care experience preferred, especially Utilization Management **Education** - Associates Degree required - Bachelor's in… more
- CenterWell (Tallahassee, FL)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- CenterWell (Tallahassee, FL)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Orthopedic procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare… more