- Actalent (Orlando, FL)
- …of cases. Essential Skills + Experience in utilization management, concurrent review , prior authorization, utilization review , case management, and ... + Active Compact RN License, Compact LPN is okay too + Utilization Management/Concurrent Review experience. + ICU/ER experience. + Strong communication… 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
- BAYADA Home Health Care (Orlando, FL)
- …+ Candidates should be available Monday-Friday from 8:30am-5:00pm. _Medicare, Coder, OASIS Review , Utilization Review , Quality Assurance, Remote, Home Health ... Home Health Care is hiring a full time OASIS Review and Coding Manager. The OASIS and Coding Review Manager provides support to all BAYADA Home Health Care… more
- BAYADA Home Health Care (Orlando, FL)
- …your career with an industry leader. Apply now for immediate consideration. OASIS Review , Utilization Review , Quality Assurance, Remote, Home Health Coding, ... Home Health Care has an immediate opening for a **Full Time,** OASIS and Coding Review Manager with OASIS and Coding certification to work remotely. RN, PT, OT, and… more
- Molina Healthcare (Tampa, FL)
- …Experience Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... / MCG guidelines. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal… more
- Sedgwick (Tallahassee, FL)
- …related line of business experience in telephonic case management (TCM) and/or utilization review or equivalent combination of education and experience required. ... Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Quality Review Nurse **PRIMARY PURPOSE** : To monitor team and colleague technical and… more
- Centene Corporation (Tallahassee, FL)
- …management, cost containment, and medical quality improvement activities. + Performs medical review activities pertaining to utilization review , quality ... physician education with respect to clinical issues and policies. + Identifies utilization review studies and evaluates adverse trends in utilization of… more
- ChenMed (North Miami Beach, FL)
- …assess and record patients' progress and adjust and plan accordingly. + Understanding utilization review and how to leverage with inpatient staff for possible ... work experience required. + A minimum of 1 year of utilization review and/or case management, home health, hospital discharge planning experience required.… more
- Evolent (Tallahassee, FL)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to make a… more
- Evolent (Tallahassee, FL)
- …the support services review process. Responsible for the quality of utilization review determinations, including appeals. + Provides input into audit ... is a key member of the Medical leadership team, providing timely medical review of service requests. Oversees the Surgery Field Medical Directors and interacts with… more