- HCA Healthcare (Pensacola, FL)
- …and admission status issues through established chain of command. + Performs utilization management reviews and communicates to third party payors. + ... supporting a balance of optimal care and appropriate resource utilization . Identify potential barriers to patient throughput and quality...Bachelor's in Nursing + 1+ year of prior case management experience + Registered Nurse - Currently… more
- Molina Healthcare (St. Petersburg, FL)
- …role must complete courses required to obtain licensure in all states. + Utilization Review Lead responsibilities also include but not limited to, collaborate ... Experience** 3-5 years clinical practice with managed care, hospital nursing, utilization and/or care management experience. **Preferred License, Certification,… more
- AdventHealth (Orlando, FL)
- …Services in the verification process. Obtains pre-authorization and provides information to the Utilization Review Specialist, Utilization Review Case ... Mission Control RN Tier 1 is a professional registered nurse functioning withing Mission Control in one of three...and placement of all patients. Proactively initiates steps, including utilization of the hospital and physician chain of command,… more
- University of Miami (Miami, FL)
- …and utilization of data used by all levels of management within the organization.5. Interacts, communicates, and intervenes with multidisciplinary healthcare ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Department of… more
- Sedgwick (Tallahassee, FL)
- …(10) of related experience required to include one (1) to three (3) years utilization review experience and three (3) years clinical quality control. **Skills & ... the following: + Conducting reviews on cases where the nurse is seeking treatment plan clarification, claim denial, disability...+ Knowledge of ADAA and FMLA + Knowledge of utilization review procedures + Knowledge of clinical… more
- HCA Healthcare (Jacksonville, FL)
- …Case Management is required for this PRN role. + Certification in Case Management or Utilization Review is preferred. + InterQual experience is ... you have the PRN career opportunities as a **Registered Nurse (RN) Case Manager** you want with your current...stay, managing the length of stay, ensuring appropriate resource management , while developing a safe appropriate discharge plan. +… more
- HCA Healthcare (Orange Park, FL)
- …Case Management is required for this PRN role.** + Certification in Case Management or Utilization Review is preferred. + InterQual experience is ... you have the PRN career opportunities as a **Registered Nurse (RN) Case Manager** you want with your current...stay, managing the length of stay, ensuring appropriate resource management , while developing a safe appropriate discharge plan. +… more
- MyFlorida (Largo, FL)
- …Paid holidays and personal day. Retirement package. REQUIREMENTS + Unencumbered Florida Registered Nurse License. + Must be willing and able to travel throughout all ... or more years of experience as a Licensed Registered Nurse in Long-Term Care facility. + Experience as a...care activities. POSITION DESCRIPTION Overview: The direct leadership and management of clinical processes and systems to assure positive… more
- HCA Healthcare (Ocala, FL)
- …hospital RN experience required + 4 year Bachelor Degree preferred + Certification in Case Management or Utilization Review preferred + 1 year experience in ... supporting a balance of optimal care and appropriate resource utilization . + Provides case management services for...and appropriate resource utilization . + Provides case management services for both inpatient and observation patients as… more
- BayCare Health System (Bradenton, FL)
- …bodies within the area of responsibility. + Ensure quality assurance program and utilization review is followed in accordance with Home Care protocol. + ... Oversees and investigates patient and physician concerns, risk management concerns and implements changes and training where necessary....Participates with Case Manager on initial Plan of Care review with a focus on quality, utilization … more