- AdventHealth (Orange City, FL)
- …of Nursing. + Health-related Master's degree or MSN. + Prior Care Management / Utilization Management experience. + ACM/CCM Certification. This facility ... Manager is under the general supervision of the Care Management Supervisor or Manager or Director of Nursing and...physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge… more
- MyFlorida (Bradenton, FL)
- SENIOR COMMUNITY HEALTH NURSE - 64080255 Date: Aug 8, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... No: 858521 Agency: Department of Health Working Title: SENIOR COMMUNITY HEALTH NURSE - 64080255 Pay Plan: Career Service Position Number: 64080255 Salary: $64,480.00… more
- HCA Healthcare (Port St. Lucie, FL)
- … experience or 2 years of critical care experience + Certification in case management or utilization review preferred + InterQual experience preferred HCA ... colleagues invested over 156,000 hours volunteering in our communities. As a(an) Registered Nurse Case Mgr RN with HCA Florida St. Lucie Hospital you can be… more
- HCA Healthcare (Aventura, FL)
- … experience or 2 years of critical care experience + Certification in case management or utilization review preferred + InterQual experience preferred HCA ... colleagues invested over 156,000 hours volunteering in our communities. As a(an) Registered Nurse Case Mgr RN PRN with HCA Florida Aventura Hospital you can be… more
- AdventHealth (Riverview, FL)
- …pathways through Bariatrics, General Surgery, Colorectal, Gastroenterology, and Reflux management , with utilization of a multidisciplinary approach. Program ... status in relation to assigned core measure(s) Performs concurrent data review and rounding for assigned patients within designated timeframe. Communicates… more
- Evolent (Tallahassee, FL)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... work with a group of nurses, providing appeal intake review for one dedicated client. They interact with coordinators...Be Doing:** + Practices and maintains the principles of utilization management and appeals management … more
- Elevance Health (Tampa, FL)
- …criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care ... **Telephonic Nurse Case Manager II** **Location: This role enables...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- Elevance Health (Tampa, FL)
- …criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care ... **Telephonic Nurse Case Manager II** **Location: Virtual: This role...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- AdventHealth (Tampa, FL)
- …patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the interdisciplinary team ... core competencies of this role. The RN Care Manager facilitates the collaborative management of patient care across the continuum, intervening to remove barriers to… more
- MTC (Panama City, FL)
- …record or other forms as appropriate. + Practice basic cost containment and utilization management for inmate care and facility operations. + Maintain absolute ... Panama City, FL. is **now hiring a part-time Registered Nurse (RN)** to join our team. **Primary duties:** +...HIPAA rules. + Accurately and promptly chart medical care. Review medical files to determine all provided services are… more