• Registered Nurse Care Manager Nights

    AdventHealth (Ocala, FL)
    …to nurses, physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge Planning and care ... (as permitted by the patient) as well as a review of the current and past inpatient and outpatient...need to succeed: .Associate and 2 years experience .Registered Nurse This facility is an equal opportunity employer and… more
    AdventHealth (08/07/25)
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  • RN Registered Nurse Care Management

    AdventHealth (Port Charlotte, FL)
    …to nurses, physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge Planning and care ... (as permitted by the patient) as well as a review of the current and past inpatient and outpatient...Associate's degree Nursing or RN Diploma degree . Registered Nurse (RN) . Two (2) years of medical/hospital nursing… more
    AdventHealth (08/07/25)
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  • Registered Nurse Hospitalist East

    AdventHealth (Orlando, FL)
    …or barriers for discharge. Avoids delay by ensuring test results are available for review and decision making. + Connects with Hospitalist providers each day to ... review discharge plans on all patients. Identifies patients that...Experience in Case Management, Managed Care, Discharge Planning and Utilization Management + Case Management training **LICENSURE, CERTIFICATION, OR… more
    AdventHealth (08/16/25)
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  • Dialysis Clinical Manager Registered Nurse…

    Fresenius Medical Center (Venice, FL)
    …all FMS manuals. + Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic, paper or voice mail, ... supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve… more
    Fresenius Medical Center (07/31/25)
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  • Registered Nurse

    MTC (Graceville, FL)
    …or other forms as appropriate. + Practice basic cost containment and utilization management for inmate care and facility operations. + Maintain absolute security ... observe applicable HIPAA rules. + Accurately and promptly chart medical care. Review medical files to determine all provided services are documented. + Closely… more
    MTC (08/20/25)
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  • Registered Nurse Wound Care

    AdventHealth (Ocala, FL)
    …in the Wound care center. This includes, but is not limited to, utilization of skills in organization, planning, implementing, evaluating, and providing care through ... use of hospital and nursing standards. **The value you'll bring to the team:** Review lab results for needed provider action and follow up. Provide initial and… more
    AdventHealth (08/19/25)
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  • Registered Nurse Wound Care PRN 12p-4p…

    AdventHealth (Ocala, FL)
    …in the Wound care center. This includes, but is not limited to, utilization of skills in organization, planning, implementing, evaluating, and providing care through ... use of hospital and nursing standards. **The value you'll bring to the team:** + Review lab results for needed provider action and follow up. + Provide initial and… more
    AdventHealth (08/07/25)
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  • Case Manager Registered Nurse

    CVS Health (Tallahassee, FL)
    …overall wellness through integration. . Using clinical tools and information/data review , conducts comprehensive assessments of member's needs and recommends an ... appropriate member care. . Attends and participates in case rounds, including utilization management rounds for behavioral health and physical health to obtain… more
    CVS Health (07/31/25)
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  • LVN Care Review Clinician, Prior…

    Molina Healthcare (St. Petersburg, FL)
    …State Plan. **JOB QUALIFICATIONS** **Required Education** Any of the following: Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program OR a ... field, such as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required Experience** 1-3 years of hospital or medical clinic… more
    Molina Healthcare (08/15/25)
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  • Care Review Clinician, PA (RN) Transplants

    Molina Healthcare (Tampa, FL)
    …Experience Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital or medical… more
    Molina Healthcare (07/17/25)
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