- Humana (Tallahassee, FL)
- …help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...Time **Required Qualifications** + Minimum of Associate Degree in nursing + Licensed Registered Nurse (RN) in… more
- CVS Health (Tallahassee, FL)
- …+ 5+ years of acute experience as a Registered Nurse + 3+ years of Utilization Management experience + 3+ year(s) of Appeals experience in Utilization ... members. **Position Summary** The Associate Manager is responsible for oversight of Utilization Management staff. This position is responsible for the… more
- Humana (Tallahassee, FL)
- …of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… 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 ... **le you'll contribute:** The role of the Emergency Department Utilization Management (UM) Registered Nurse ...Preferred. 3 years experience. 3 years acute care clinical nursing experience. 2 Utilization Management … more
- Cognizant (Tallahassee, FL)
- …background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Elevance Health (Miami, FL)
- ** Utilization Management Representative I** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person ... to 6:30 PM Eastern. Training hours may vary. The ** Utilization Management Representative I** is responsible for...requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification and data… more
- Elevance Health (Tampa, FL)
- ** Utilization Management Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... (four 10-hour workdays per week) Monday - Sunday.** The ** Utilization Management Representative I** will be responsible...requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification and data… more
- Humana (Tallahassee, FL)
- …put health first** The UM Administration Coordinator contributes to administration of utilization management . The UM Administration Coordinator 2 performs varied ... treatment, care or services for members utilizing Home Health and Skilled Nursing Facility services. This team sits in the Home Solutions organization and… more
- ERP International (Macdill AFB, FL)
- …is seeking a **Registered** ** Nurse (RN)** for a Full-Time position in ** Utilization Management ** at MacDill AFB, FL. Apply online today and discover more ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
- Actalent (Fort Lauderdale, FL)
- … Utilization Review Nurse Job Description We are seeking a dedicated Utilization Management Nurse (UMN) who will work collaboratively with an ... and present reports on department activities as assigned. Essential Skills + Utilization management + Behavioral Health + Mental Health + Clinical review + … more