- Veterans Affairs, Veterans Health Administration (Pensacola, FL)
- …with patient and forward more advanced questions to the imaging technologist, utilization nurse , or professional staff. Documents communication interactions in ... the patient's digital medical records. Customer service and professionalism are paramount skills within this duty. Works with Imaging Service staff to ensure imaging orders are protocoled by a professional staff member prior to the appointment date. Works with… more
- BayCare Health System (Clearwater, FL)
- …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior responsibilities include:** + Functions as the ... review for medical necessity of outpatient observation and inpatient stays and the utilization of ancillary services + Perform other duties as assigned by the… more
- Centene Corporation (Tallahassee, FL)
- …applied behavioral analytics (ABA). Additional Details: * Department: Behavioral Health Utilization Management * Business Unit: Corporate / Florida * Schedule: ... Analyzes BH member data to improve quality and appropriate utilization of services + Interacts with BH healthcare providers...Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required… more
- Centene Corporation (Tallahassee, FL)
- …discharge planning + Analyzes BH member data to improve quality and appropriate utilization of services + Provides education to providers members and their families ... regrading BH utilization process + Interacts with BH healthcare providers as...Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required… more
- Elevance Health (FL)
- ** Utilization Management Representative I** **Location:** Virtual: This role enables associates to work virtually full-time, with the exception of required in-person ... shift between 8 am - 8 pm EST. The ** Utilization Management Representative I** is responsible for coordinating cases...requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification and data… more
- ChenMed (Pembroke Pines, FL)
- …We're rapidly expanding and we need great people to join our team. The Nurse Case Manager I position is responsible for achieving positive patient outcomes and ... manage quality of care across the continuum of care. The Nurse Case Manager I will first and foremost serve as an advocate for our patients. In this capacity, this… more
- MyFlorida (Macclenny, FL)
- REGISTERED NURSE SPECIALIST OPS - 60953538 Date: Aug 21, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 859389 Agency: Children and Families Working Title: REGISTERED NURSE SPECIALIST OPS - 60953538 Pay Plan: Temp Position Number: 60953538 Salary:… more
- MyFlorida (Chattahoochee, FL)
- REGISTERED NURSE SUPERVISOR - 60005446 Date: Aug 13, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 858609 Agency: Children and Families Working Title: REGISTERED NURSE SUPERVISOR - 60005446 Pay Plan: Career Service Position Number: 60005446… more
- Evolent (Tallahassee, FL)
- …a mission with a company behind it. **What You'll Be Doing:** As a Clinical Reviewer, Nurse , you will be a key member of the utilization management team. We can ... providing better health outcomes. **Collaboration Opportunities:** As a Clinical Reviewer, Nurse , you will routinely interact with leadership and management staff,… more
- Evolent (Tallahassee, FL)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Clinical Reviewer, Nurse , you will be a key member of the utilization management team. We ... providing better health outcomes. **Collaboration Opportunities:** As a Clinical Reviewer, Nurse , you will routinely interact with leadership and management staff,… more