- Humana (Tallahassee, FL)
- … licensure + Previous Medicare/Medicaid experience a plus + Previous experience in utilization management , case management , discharge planning and/or home ... review depending on case findings. + Educates providers on utilization and medical management processes. + Enters...health or rehab + Certification in Case Management (CCM) or Managed Care Nursing (CMCN)… more
- AdventHealth (Orange City, FL)
- …of Nursing . + Health-related Master's degree or MSN. + Prior Care Management / Utilization Management experience. + ACM/CCM Certification. This facility is ... Manager is under the general supervision of the Care Management Supervisor or Manager or Director of Nursing...need to succeed:** **Minimum qualifications** : + Associate's degree Nursing or RN Diploma degree. + Registered Nurse… more
- ChenMed (Tamarac, FL)
- …Readmission Rate Advance directives/End of Life Planning Patient Satisfaction Utilization /Financial Management -managing resource utilization and ... setting. EDUCATION AND EXPERIENCE CRITERIA: + ARNP or similar advanced degree in Nursing required + Current Nurse Practitioner Certification in the State of… more
- Humana (Miramar, FL)
- …providers to ensure cohesive and evidence-based care. - Oversee and optimize utilization management processes within the organization. - Ensure resource ... Home Health Wound Ostomy Care RN is a specialized nursing position primarily focused on assessing documentation from field...practices in wound care but also aim at controlling utilization to improve patient outcomes. The expertise of a… more
- CVS Health (Tallahassee, FL)
- …+ 5+ years of acute experience as a Registered Nurse + 3+ years of Utilization Management experience + Must have experience using MS Office + Must be willing ... level. The Associate Manager is also responsible for oversight of utilization management nurses including the organization and development of high performing… more
- CenterWell (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... high-volume community or mail order pharmacy practice environment + Previous experience in utilization management + Education: BSN or Bachelor's degree in a… more
- Select Medical (Panama City, FL)
- … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... current licensure in a clinical discipline either as a Nurse or a Respiratory Therapist OR Social Work SW/MSW...what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning,… more
- Select Medical (Orlando, FL)
- … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... current licensure in a clinical discipline either as a Nurse (RN/LPN/LVN) or a Respiratory Therapist (RT) OR Medical...what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning,… more
- AdventHealth (Winter Park, FL)
- …the ANA Scope and Standard for Nursing Practice, and the AONE Nurse Executive Competencies. *Liaises between Care Management , Nursing , and Hospital ... population. The Expeditor partners with physicians and providers, care management team, nursing teams, and support service...Case Management , Managed Care, Discharge Planning and Utilization Management *Case Management training… more
- Molina Healthcare (Miami, FL)
- …State Registered Nursing (RN) license in good standing. + Utilization Management Certification (CPHM) Certified Professional in Health Care Quality ... management initiatives and analytical studies aimed at optimizing utilization of medical resources and maximizing operational efficiencies. + Engages with… more