- Bluestone Physician Services (Venice, FL)
- …with primary care teams to ensure high quality team-based care Use utilization management tools to facilitate appropriate transitional care management ... position allows for great work-life balance, with approximately 20% remote and 80% of the time allowing you to...Degree in Social Work, Licensed Social Worker or Registered Nurse 3-5 years of experience in case/care management… more
- CVS Health (Tallahassee, FL)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and knowledge in ... and every day. **Position Summary** This is a fully remote role open to candidates with an active RN...to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking… more
- Actalent (Sunrise, FL)
- Utilization Management Nurse !Job Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing service authorization ... activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management ...involving shadowing a team member on-site on Tuesdays and remote shadowing via Teams. Pay and Benefits The pay… more
- Sharecare (Tallahassee, FL)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
- ChenMed (Miami, FL)
- …expanding and we need great people to join our team. The Registered Nurse , Telehealth is responsible for providing telephonic triage directional patient care advice ... issues, client counseling, patient advocacy, health education and referral and resource management to ChenMed patients and their families. The incumbent in this role… more
- Prime Therapeutics (Tallahassee, FL)
- …and drives every decision we make. **Job Posting Title** Infusion Referral Nurse - REMOTE **Job Description** Under supervision, is responsible for performing ... Nursing + Bachelors - Nursing + RN - Registered Nurse , State and/or Compact State Licensure - Care Mgmt...experience. + Experience in managed care, specialty drugs, care management and utilization review. + Meets Credentialing… more
- Centene Corporation (Tallahassee, FL)
- …28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive ... Analyzes BH member data to improve quality and appropriate utilization of services + Provides education to providers members...Complies with all policies and standards **This is a remote position. We require candidates to be located and… more
- Molina Healthcare (FL)
- …Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + ... _For this position we are seeking a (RN) Registered Nurse who must be licensed for the state of...be required. + Serves as a clinical resource for Utilization Management , Chief Medical Officer, Physicians, and… more
- AdventHealth (Altamonte Springs, FL)
- …Support Registered Nurse is responsible for providing telephonic medical case management for Workers Compensation Injury cases. Case Management is a ... youll bring to the team:** + Provide telephonic case management for multi-state claim caseload assignment (excluding GA: written...written consent required, and NC: must be registered rehab nurse with NCIC) + Reports directly to the WC… more
- ChenMed (Winter Park, FL)
- …license required if available in state. + A minimum of 2 years' onsite case management at ChenMed and/or utilization review or discharge planning in a hospital ... markets to deliver on managing their case load by providing onsite and remote planning, clinical group leadership and expert technical guidance to their team.… more
