- 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)
- …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
- Humana (Tallahassee, FL)
- …help us put health first** The Utilization Management Registered 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 varied and frequently… 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 ... nursing experience Preferred + 1 years of Utilization Management experience Preferred This facility is… 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...care nursing experience preferred. 1 years of utilization management experience preferred. This facility is… more
- CenterWell (Tallahassee, FL)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... license + Possession of or ability to obtain Compact Nursing License + A minimum of three years clinical...DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous… more
- CenterWell (Tallahassee, FL)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... license + Possession of or ability to obtain Compact Nursing License + A minimum of three years clinical...procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous… more
- CVS Health (Tallahassee, FL)
- …every day. **Position Summary** **Fully remote with requirement to reside in Florida.** + Utilization Management is a 24/7 operation and the work schedule may ... in Florida + 3+ years of clinical experience + Utilization Management is a 24/7 operation and...MCO **Education** + Diploma RN or Associates degree in Nursing required + BSN preferred **Anticipated Weekly Hours** 40… more
- Florida Health Care Plans, Inc. (Daytona Beach, FL)
- …within the community to various locations. POSITION SUMMARY: As part of the Utilization Management division, the social worker will intervene with members who ... engage with members and their families, travel to hospitals, rehab or skilled nursing facilities and possibly member's homes, may be required. The ability to develop… more