- Adecco US, Inc. (Altamonte Springs, FL)
- …. Demonstrates a thorough understanding of the cost consequences resulting from Care Management decisions through utilization of reports and systems such as ... experience in an acute clinical care setting or equivalent. . Previous care management , utilization review or discharge planning experience. . RN License in… more
- Select Medical (Jacksonville, FL)
- …allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and ... of the discharge planning process. + The primary job functions in Case Management include: + Clinical Interventions/Discharge Planning + Care Planning Management … more
- Select Medical (Gainesville, FL)
- …allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and ... of the discharge planning process. + The primary job functions in Case Management include: + Clinical Interventions/Discharge Planning + Care Planning Management … more
- Elevance Health (FL)
- …patients with IDD and patients with special needs is preferred. + Home Health, Utilization Management or Case Management experience strongly preferred. + ... agencies and appropriate provider/network. + Refers member to catastrophic case management . **Minimum Requirements:** Requires AS in nursing and minimum… more
- Molina Healthcare (St. Petersburg, FL)
- …**Preferred Experience** 3-5 years clinical practice with managed care, hospital nursing , utilization and/or care management experience. **Preferred ... the health plan HCS Department staff. Consults with the Management of HCS to devise and implement corrective action...courses required to obtain licensure in all states. + Utilization Review Lead responsibilities also include but not limited… more
- Prime Therapeutics (Tallahassee, FL)
- …Patient Programs. **Education & Experience** + Associates - Nursing + Bachelors - Nursing + RN - Registered Nurse , State and/or Compact State Licensure - ... of post-degree clinical experience. + Experience in managed care, specialty drugs, care management and utilization review. + Meets Credentialing criteria. + At… more
- AdventHealth (New Smyrna Beach, FL)
- …expertise and experiences you'll need to succeed:** **Minimum qualifications** : + Bachelors of Nursing + Registered Nurse in the State of Florida + Advanced ... business hours, acting as a pivotal clinical resource facilitator for the nursing areas. This role is crucial in fostering intradepartmental communication and… more
- Veterans Affairs, Veterans Health Administration (Lake City, FL)
- …and improved: Access, Quality of Care, Customer Service/Patient Satisfaction, and Utilization Management /Efficiency of Care. Coordinates orientation and, in ... coordinates and directs comprehensive, interdisciplinary team of psychologist, psychiatrist, nurse , social worker, admin support staff, ensuring a smooth continuum… more
- Molina Healthcare (FL)
- …Medical, or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina ... QUALIFICATIONS** **Required Education** Graduate from an Accredited School of Nursing . **Required Experience** 3+ years hospital acute care/medical experience.… more
- AdventHealth (Riverview, FL)
- …pathways through Bariatrics, General Surgery, Colorectal, Gastroenterology, and Reflux management , with utilization of a multidisciplinary approach. Program ... to succeed** **:** Graduate of an accredited School of Nursing 3 years of clinical experience in a specialized...platform or data collection within a healthcare setting. Registered Nurse (RN) Licensed Practical Nurse (LPN) or… more