- Humana (Tallahassee, FL)
- …enterprise leader, with responsibility for evolving Humana's Utilization Management of medical review by physician or nurse , with a focus on our 5+ million ... The Director, Physician leadership will lead Medical Directors performing utilization management for inpatient authorizations training medical director team to… more
- 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 (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 (Orlando, FL)
- …the Chief Medical Officer. + Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the ... and interacts with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource… more
- CenterWell (Deland, FL)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's… 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 ... location._** It is an exciting time to be a nurse at HCA Healthcare! Come unlock your career potential...supporting a balance of optimal care and appropriate resource utilization . The RN CM Care Coordinator will identify potential… more
- University of Miami (Miami, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The ... Responsibilities require close interaction with physicians and department directors/managers, nurse coordinators and ARNP's regarding interpretation and distribution of… more
- Matrix Providers (Jacksonville, FL)
- …ratios and fair, reliable schedules. Matrix Providers is hiring a Licensed Practical Nurse /Licensed Vocational Nurse - Pain Management to join our team of ... + Degree: Be a graduate from a Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN)...coordinating with the local Medical Home Port (MHP) clinic, utilization and Referral Management policies, and obtains additional clinical… more
- Molina Healthcare (St. Petersburg, FL)
- …role must complete courses required to obtain licensure in all states. + Utilization Review Lead responsibilities also include but not limited to, collaborate ... timely completion. + Actively participates in the Department auditing program to review and communicate findings with staff and identify opportunities for improved… more
- Select Medical (Gainesville, FL)
- …and professional growth of the department, including, but not limited to: Utilization Review (UR) and resource management, discharge planning, treatment plan ... of Case Management** **$10,000 Sign On Bonus** **_Clinical license as a registered nurse or respiratory therapist or master's in social work and minimum three (3)… more