- HCA Healthcare (Gainesville, FL)
- …and integrity. We care like family! Jump-start your career as a Behavioral Health Utilization Review RN MSW today with Parallon. **Benefits** Parallon offers a ... benefits may vary by location._** Come join our team as a Behavioral Health Utilization Review RN MSW. We care for our community! Just last year, HCA Healthcare… more
- HCA Healthcare (Port St. Lucie, FL)
- **Description** **Introduction** Do you have the career opportunities as a Utilization Review Services Coordinator you want with your current employer? We have ... caring group of colleagues. Do you want to work as a Utilization Review Services Coordinator where your passion for creating positive patient interactions is… more
- Centene Corporation (Tallahassee, FL)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... a fresh perspective on workplace flexibility. **Position Purpose:** Performs a clinical review and assesses care related to mental health and substance abuse.… more
- Molina Healthcare (Tampa, FL)
- …and Monitoring team responsible for prior authorizations, inpatient/outpatient medical necessity/ utilization review , and/or other utilization management ... + Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of InterQual / MCG guidelines.… 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 active and ... a collaborative process to implement, coordinate, monitor and evaluate medical review cases. + Applies the appropriate clinical criteria/guideline and plan language… more
- Actalent (Sunrise, FL)
- …UMN assists in complex cases, develops internal processes, and educates physicians on utilization review issues. The role involves managing continuity of care, ... and present reports on department activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management + InterQual +… more
- Community Health Systems (Naples, FL)
- …improvement programs + Addresses facility and departmental communication through daily review of all correspondence, including incoming email messages. + Performs ... other duties as assigned. + Complies with all policies and standards. **Qualifications** + Associate Degree Graduate from an Accredited School of Nursing, ASN required or + Bachelor's Degree BSN required + 2-4 years clinical practice experience required +… more
- CenterWell (Tallahassee, FL)
- …member service or customer service telephone experience desired + Experience with Utilization Review and/or Prior Authorization, preferably within a managed care ... of our caring community and help us put health first** The Utilization Management (UM) Administrative Coordinator 2 is responsible for providing high-quality support… more
- Molina Healthcare (Miami, FL)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... / MCG guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). MULTI STATE / COMPACT LICENSURE… more
- Molina Healthcare (St. Petersburg, FL)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... / MCG guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). **MULTI STATE / COMPACT LICENSURE**… more