- BayCare Health System (Tampa, FL)
- …Call:** No **Certifications and Licensures:** + Required RN ( Registered Nurse ) + Preferred ACM (Case Management ) + Preferred CCM (Case Manager) ... of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/ RN responsibilities include:** +...Case Management or + Required 3 years Registered Nurse + Preferred experience in Critical… more
- HCA Healthcare (Lake City, FL)
- …chain of command in a timely manner. **What qualifications you will need:** + ( RN ) Registered Nurse + Associate Degree + One year experience ... and/or managed care setting required. + Current State of Florida license for Registered Nurse or appropriate compact licensure. If compact license held, active… more
- Molina Healthcare (Miami, FL)
- …skills. * Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications * Registered Nurse ( RN ). License must be active and ... including design, development, implementation, and oversight of technology that drives core utilization management , care management , long-term services and… more
- Centene Corporation (Tallahassee, FL)
- …of Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. **License/Certification:** + LPN or RN - FL ... plans, and actions taken on member medical records in health management systems according to utilization management policies and guidelines + Works with… 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 ... Be Doing:** + Practices and maintains the principles of utilization management and appeals management ...and Preferred:** + 1-3 years' experience and as an RN - **Required** + Minimum of 5 years in… more
- Molina Healthcare (FL)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. **Required Qualifications** * At least 2… more
- HCA Healthcare (Brooksville, FL)
- …of experience in a healthcare environment + Previous experience in accreditation, quality, utilization management , or risk management required. + Knowledge ... and Qualifications** We are seeking a Director of Quality Management . As our Director, you will provide direction to...you will provide direction to ensure the facilitation and utilization of diverse strategies and communication for quality and… more
- HCA Healthcare (Port Charlotte, FL)
- …your knowledge and expertise! **Job Summary and Qualifications** We are seeking a Registered Nurse Case Manager. You will provide clinical expertise to ensure ... you have the career opportunities as a(an) Case Manager RN you want with your current employer? We have...will promote cost effectiveness through the integration of case management , utilization review management and… more
- HCA Healthcare (Bradenton, FL)
- …be a part of our team. **Job Summary and Qualifications** We are seeking a Registered Nurse Case Manager. You will provide clinical expertise to ensure all ... organization that invests in you as a(an) Case Manager RN ? At HCA Florida Blake Hospital, you come first....will promote cost effectiveness through the integration of case management , utilization review management and… more
- HCA Healthcare (St. Petersburg, FL)
- …charitable organizations. Apply Today! **Job Summary and Qualifications** We are seeking a Registered Nurse Case Manager. You will provide clinical expertise to ... like family! Jump-start your career as a(an) Case Manager RN PRN today with HCA Florida St. Petersburg Hospital....will promote cost effectiveness through the integration of case management , utilization review management and… more