- 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CVS Health (Tallahassee, FL)
- … (RN) - active license. + 3+ Years of clinical experience. + 1+ Year of Utilization Review Management and/or Medical Management experience. + Must have ... procedures/services or initiate a Medical Director referral as needed. + Assists management with training new nurse reviewers/business partners or vendors to… more
- Actalent (Sunrise, FL)
- Utilization Management Nurse !Job Description The ...Skills + Clinical review + Utilization review + Utilization management + Interqual ... Utilization Management Nurse (UMN) plays a crucial role in reviewing service...+ Valid Florida Driver's License. + Knowledge of case management and utilization review concepts,… more
- Veterans Affairs, Veterans Health Administration (Orlando, FL)
- …Revenue, Billing, Insurance Verification, Veteran Services, Compliance, Providers, Health Information Management (HIM), Utilization Management (UM), and ... on Service Connection (SC), non-SC, Special Authority (SA), precertification, prospective review , concurrent review , denial management , retrospective … more
- 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
- 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)
- …failure, cancer and other diseases. **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse (RN) is to use clinical ... reviews within 24 hours of admission; and when warranted by length of stay, utilization review plan, and/or best practice guidelines, on a continuing basis.… 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 ... foundation of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior responsibilities include:** + Functions… more
- BayCare Health System (Clearwater, 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 ... foundation of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior responsibilities include:** + Functions… 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