- Actalent (Sunrise, FL)
- Actalent is hiring a Utilization Management Nurse ! Job...+ Clinical review + Utilization review + Utilization management + ... Description The Utilization Management Nurse (UMN) collaborates closely with the interdisciplinary team to...+ Valid Florida Driver's License. + Knowledge of case management and utilization review concepts,… more
- Actalent (Orlando, FL)
- Job Title: Clinical Review Nurse Job Description As a...care. Essential Skills + Proficiency in utilization management and utilization review + ... Clinical Review Nurse , you will perform concurrent reviews to assess members'...ER, Med-Surge, PACU, etc. + Strong multitasking and time management abilities. + Quick learner with a go-with-the-flow attitude.… more
- CVS Health (Tallahassee, FL)
- …work._ **Required Qualifications** + 1 year of varied UM ( utilization management ) experience within an **outpatient** setting, concurrent review or prior ... thorough, independent decisions using clinical judgement. + A Registered Nurse that must hold an unrestricted license in their...+ 1 year of varied UM ( utilization management ) experience within an inpatient, concurrent review … 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
- AdventHealth (Tampa, FL)
- …designated leader for additional review as determined by department standards. The Utilization Management Nurse is accountable for a designated patient ... diseases. **The role you'll contribute:** The role of the Emergency Department Utilization Management (UM) Registered Nurse (RN) is to use clinical expertise… 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 ... of admission; and when warranted by length of stay, utilization review plan, and/or best practice guidelines,...of critical 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 ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- CenterWell (Tallahassee, FL)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Orthopedic procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare… more
- Centene Corporation (Tallahassee, FL)
- …be located in eastern or central time zone with experience in utilization management .** **Education/Experience:** Requires Graduate of an Accredited School ... and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and… more
- Centene Corporation (Tallahassee, FL)
- …in applied behavioral analytics (ABA). Additional Details: * Department: Behavioral Health Utilization Management * Business Unit: Corporate / Florida * ... assess ABA Treatment Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with providers and healthcare… more