- Evolent (Tallahassee, FL)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... Radiology you will be a key member of the utilization management team. We can offer you a meaningful...rationale for standard and expedited appeals. + Utilizes medical/clinical review guidelines and parameters to assure consistency in the… more
- HCA Healthcare (Kissimmee, FL)
- …and improve the patient flow program effectiveness as it relates to utilization review , resource management, and discharge planning and care coordination. ... the educational leader to physicians and employees as it relates to utilization review , resource management, patient flow, multi-disciplinary rounds and hospital… more
- HCA Healthcare (Tallahassee, FL)
- …position if current and compliant** + **Certification in Case Management, Nursing, or Utilization Review , preferred** + **Three years of nursing experience in ... throughput while supporting a balance of optimal care and appropriate resource utilization . The RN CM Care Coordinator will identify potential barriers to patient… more
- HCA Healthcare (Tallahassee, FL)
- …position if current and compliant** + **Certification in Case Management, Nursing, or Utilization Review , preferred** + **Three years of nursing experience in ... throughput while supporting a balance of optimal care and appropriate resource utilization . The RN CM Care Coordinator will identify potential barriers to patient… more
- HCA Healthcare (Tallahassee, FL)
- …for position if current and compliant + Certification in Case Management, Nursing, or Utilization Review , preferred + Three years of nursing experience in acute ... throughput while supporting a balance of optimal care and appropriate resource utilization . The RN CM Care Coordinator will identify potential barriers to patient… more
- Elevance Health (Tampa, FL)
- …physical and/or behavioral health practitioners responsible for coordinating member service, utilization , access, care management and/or concurrent review to ... an accommodation is granted as required by law. *Must reside in the state of Florida* The **Manager of Utilization Management** is responsible for managing a team of… more
- CenterWell (Madison, FL)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... and documentation requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance review … more
- Community Based Care of Brevard, Inc. (Brevard, FL)
- …payments and alternative funding sources whenever possible. The position facilitates Team Review Meetings and the utilization review process, reviews ... Position Summary: This position is responsible for the clinical coordination, utilization management, and authorization of initial and ongoing services for children… more
- CenterWell (Ocala, FL)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... and documentation requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance review … more
- HCA Healthcare (Sanford, FL)
- …is preferred + BSN is preferred + Certification in Case Management, Nursing or Utilization Review is preferred HCA Florida Lake Monroe Hospital is a 221-bed ... supporting a balance of optimal care and appropriate resource utilization . You would be part of a phenomenal team...apply for our RN Case Manager opening. We promptly review all applications. Highly qualified candidates will be directly… more