- AdventHealth (Tampa, FL)
- …The Utilization Management RN Supervisor reports directly to the Divisional Utilization Management RN Manager and assists in monitoring and performing the ... is responsible for the daily administrative tasks as assigned by the Utilization Management RN Manager . The Supervisor will serve as the primary point of contact… more
- CenterWell (Tampa, FL)
- …for managing populations and coordinating care to reduce acute and post-acute care utilization . The Manager role is hybrid with travel requirements to preferred ... caring community and help us put health first** The Manager Care/Case Management in **Tampa area (** **_this is...action plans that will reduce acute and post-acute care utilization . + Solicits/shares feedback with market leaders on team-based… more
- Healthfirst (FL)
- The Case Manager , Utilization Management coordinates the care plan for assigned members and conducts pre-certification, concurrent review, discharge planning, ... and case management as assigned. The Case Manager , Utilization Management is also responsible for efficient utilization of health services and optimal health… more
- Select Medical (Pensacola, FL)
- …high-quality care and doing well by doing what is right. The Case Manager is responsible for utilization reviews and resource management, discharge planning, ... **Overview** **Critical Illness Recovery Hospital** **Case Manager (PRN)** _Requires a current licensure in a...safe and timely discharge plan. + Performs verification of utilization criteria reviews. + Builds relationships and coordinate with… more
- Select Medical (Orlando, FL)
- …high-quality care and doing well by doing what is right. The Case Manager is responsible for utilization reviews and resource management, discharge planning, ... **Overview** **Critical Illness Recovery Hospital** **Case Manager ** _Requires a current licensure in a clinical...safe and timely discharge plan. + Performs verification of utilization criteria reviews. + Builds relationships and coordinate with… more
- CenterWell (Tallahassee, FL)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work ... 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 to ... procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare/Medicaid… more
- Trinity Health (Fort Lauderdale, FL)
- …Plans to ensure authorization for hospital stay. Hybrid Position **_Position Purpose:_** ** Utilization Review (UR) Nurses play a vital role in healthcare by making ... as a preceptor for case managers in the Observation Case Manager role.** Responsible for educating and communicating Physicians regarding appropriate** Assumes… more
- Community Health Systems (Naples, FL)
- **Job Summary** Under the direction of the UR Director/ Manager the UR Nurse reviews all admissions for medical necessity, correct orders based on medical condition ... (inpt vs OBS). Facilitates concurrent reviews and authorizations for admissions. This position will support the development of policies and procedures, standard work and educational materials for the UR department. Will be a partner with other staff members,… more
- AdventHealth (Land O' Lakes, FL)
- …outcomes within effective time frames on a specific group of patients.The Case Manager is responsible for utilization reviews and resource management, discharge ... (Respiratory), Service Awards, TWCE as Nice The role you'll contribute: The Case Manager is accountable for the organization, sequence of services and resources that… more