- Actalent (Sunrise, FL)
- …+ Prepare and present reports on department activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management + ... policy guidelines. + Promote safe and appropriate coordination of care and optimal utilization of resources. +...or LPN License. + Minimum of one year of utilization review experience and discharge planning in… more
- BayCare Health System (Clearwater, FL)
- …foundation of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior responsibilities include:** + Functions ... all other related parties to ensure appropriate level of care through comprehensive concurrent review for medical...Nursing or Business **Experience:** + Required 2 years in Utilization Review or + Required 2 years… 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 ... Medical Record + Works with healthcare providers to ensure complete and accurate condition and care of the patient + Serves as a resource to support the UR team in… more
- CenterWell (Tallahassee, FL)
- …and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... of three years clinical RN experience; + Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience +… more
- BAYADA Home Health Care (Orlando, FL)
- …around this requirement.** BAYADA Home Health Care is hiring a full time OASIS Review and Coding Manager . The OASIS and Coding Review Manager ... Minimum of 1 year experience with coding and OASIS review . + Knowledge of OASIS, Home Care ...should be available Monday-Friday from 8:30am-5:00pm. _Medicare, Coder, OASIS Review , Utilization Review , Quality Assurance,… more
- ChenMed (Pembroke Pines, FL)
- …+ Facilitates interdisciplinary patient care rounds and/or conferences to review treatment goals, optimize resource utilization , provide family education and ... quality of care across the continuum of care . The Nurse Case Manager I will...with patient and family. + Facilitate patient/family conferences to review treatment goals, optimize resource utilization , provide… more
- AdventHealth (Orlando, FL)
- …7727 LAKE UNDERHILL ROAD, Orlando, 32822 **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses, ... care coordination and progression through the continuum of care . The RN Care Manager ...as needed. Actively participates in daily Multidisciplinary Rounds to review progression of care and discharge plan… more
- BAYADA Home Health Care (Orlando, FL)
- …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, ... your career with an industry leader. Apply now for immediate consideration. OASIS Review , Utilization Review , Quality Assurance, Remote, Home Health Coding,… more
- AdventHealth (New Smyrna Beach, FL)
- …DIXIE HWY, New Smyrna Beach, 32168 **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses, ... care coordination and progression through the continuum of care . The RN Care Manager ...BSN + Health-related Master's degree or MSN + Prior Care Management/ Utilization Management experience ACM/CCM Certification This… more
- AdventHealth (Deland, FL)
- …701 W PLYMOUTH AVE, Deland, 32720 The role you'll contribute: The RN Care Manager in collaboration with the patient/family, social workers, nurses, physicians ... care coordination and progression through the continuum of care . The RN Care Manager ...BSN + Health-related Master's degree or MSN + Prior Care Management/ Utilization Management experience ACM/CCM Certification This… more