- CVS Health (Tallahassee, FL)
- …Texas, Virginia and West Virginia. This Medical Director will be a "Work from Home " position primarily supporting Aetna Better Health of Florida as well as ... At CVS Health , we're building a world of health...responses to members and providers related to precertification, concurrent review , and appeal request. This position is primarily responsible… more
- HCA Healthcare (Gainesville, FL)
- …physical, psycho-social, financial). + Participates in IDT rounds, + Conducts utilization review , evaluates clinical information, and communicates findings to ... what matters most to nurses like you - at home , at work, and at every stage in your...on a timely basis in accordance with the NFRMC Utilization Review Plan and managed care contractual… 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 ... HCA Florida Capital Hospital, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The available plans and… more
- CVS Health (Jacksonville, FL)
- …consistent responses to members and providers. Leads all aspects of utilization review /quality assurance, directing case management Provides clinical expertise ... At CVS Health , we're building a world of health around... care resources. **This is a remote based (work at home ) based anywhere in the US.** Aetna, a CVS … more
- MyFlorida (Bradenton, FL)
- SENIOR COMMUNITY HEALTH NURSE - 64080249 Date: Aug 8, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... (http://www.dms.myflorida.com/workforce\_operations/human\_resource\_management/for\_job\_applicants/e\_verify) . Requisition No: 858432 Agency: Department of Health Working Title: SENIOR COMMUNITY HEALTH NURSE… more
- Veterans Affairs, Veterans Health Administration (Sarasota, FL)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... or unit making sure to provide prompt and appropriate treatment for Veterans health concerns to ensure care is timely. The nurse demonstrates high quality customer… more
- HCA Healthcare (Ocala, FL)
- …Florida West Marion Hospital, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The available plans and ... cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.… more
- Evolent (Tallahassee, FL)
- …experience and as an RN - **Required** + Minimum of 5 years in Utilization Management, health care Appeals, compliance and/or grievances/complaints in a quality ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes...appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies… 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 ... part of our caring community and help us put health first** Utilization Management Administration Coordinator II...senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy… more
- CVS Health (Milton, FL)
- …your understanding of patient safety and error prevention, quality assurance drug utilization review (DUR), pharmacy professional standards such as corresponding ... culture of continuous improvement, with the goal of changing health care for the better. **Position Summary:** At CVS...an essential pharmacist function + Ability to work in home store, and across the market in other locations,… more