- Actalent (Fort Lauderdale, FL)
- Actalent is Hiring a Behavioral Health Utilization Review Nurse Job Description We are seeking a dedicated Utilization Management Nurse (UMN) who ... experience. + Valid Florida Driver's License. + Knowledge of case management and utilization review concepts, including InterQual and Milliman Criteria,… more
- Actalent (Sunrise, FL)
- Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing ... Qualifications + Valid Florida Driver's License. + Knowledge of case management and utilization review concepts, including InterQual and Milliman Criteria. +… more
- AdventHealth (Tampa, FL)
- …designated leader for additional review as determined by department standards. The Utilization Management Nurse is accountable for a designated patient ... **The ro** **le you'll contribute:** The role of the Emergency Department Utilization Management (UM) Registered Nurse (RN) is to use clinical expertise… 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
- Lincoln Financial (Tallahassee, FL)
- …Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management ... Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible for… more
- BayCare Health System (Tampa, FL)
- …2 years in Utilization Review or + Required 2 years in Case Management or + Required 3 years Registered Nurse + Preferred experience in Critical Care or ... of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN responsibilities include:** + Functions… more
- Centene Corporation (Tallahassee, FL)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** 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...in an acute care setting + Previous experience in utilization management / utilization review … 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
- 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...and post service requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible… more