- Actalent (Sunrise, FL)
- Actalent is hiring a Utilization Management Nurse ! Job...+ Clinical review + Utilization review + Utilization management + ... Description The Utilization Management Nurse (UMN) collaborates closely with the interdisciplinary team to...+ Valid Florida Driver's License. + Knowledge of case management and utilization review concepts,… 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 ... of admission; and when warranted by length of stay, utilization review plan, and/or best practice guidelines,...of critical care nursing experience preferred. 1 years of utilization management experience preferred. This facility is… more
- CVS Health (Tallahassee, FL)
- …work._ **Required Qualifications** + 1 year of varied UM ( utilization management ) experience within an **outpatient** setting, concurrent review or prior ... thorough, independent decisions using clinical judgement. + A Registered Nurse that must hold an unrestricted license in their...+ 1 year of varied UM ( utilization management ) experience within an inpatient, concurrent review … more
- Actalent (Sunrise, FL)
- Utilization Management Nurse !Job Description The ...Skills + Clinical review + Utilization review + Utilization management + Interqual ... Utilization Management Nurse (UMN) plays a crucial role in reviewing service...+ Valid Florida Driver's License. + Knowledge of case management and utilization review concepts,… more
- CVS Health (Tallahassee, FL)
- … (RN) - active license. + 3+ Years of clinical experience. + 1+ Year of Utilization Review Management and/or Medical Management experience. + Must have ... procedures/services or initiate a Medical Director referral as needed. + Assists management with training new nurse reviewers/business partners or vendors to… 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
- Evolent (Tallahassee, FL)
- …As a Clinical Reviewer , Nurse , you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in ... Clinical Reviewers are supported by Field Medical Directors (MDs) in the utilization management determination process. + Reviews charts and analyzes clinical… more
- Evolent (Tallahassee, FL)
- …As a Clinical Reviewer , Nurse , you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in ... Clinical Reviewers are supported by Field Medical Directors (MDs) in the utilization management determination process. + Reviews charts and analyzes clinical… more