- MTC (Graceville, FL)
- …medical team who are dedicated to improving people's lives. We are seeking an **On-Call Registered Nurse ( RN )** to join our team. **Primary duties:** + ... forms as appropriate. + Practice basic cost containment and utilization management for inmate care and facility operations. +...HIPAA rules. + Accurately and promptly chart medical care. Review medical files to determine all provided services are… more
- Humana (Tallahassee, FL)
- …an impact** **Use your skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the (appropriate state) with no ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing...in an acute care setting + Previous experience in utilization management/ utilization review for a… more
- MTC (Quincy, FL)
- …of nursing skills all in one package!** Are you a dedicated and skilled RN looking for a meaningful opportunity to provide exceptional care? We're hiring passionate ... forms as appropriate. + Practice basic cost containment and utilization management for inmate care and facility operations. +...HIPAA rules. + Accurately and promptly chart medical care. Review medical files to determine all provided services are… more
- 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 ... standards. **The value you'll bring to the team:** + Review lab results for needed provider action and follow...need to succeed:** Completion of Nursing Program Active Florida RN License Current BLS This facility is an equal… more
- BayCare Health System (St. Petersburg, FL)
- … Management or 6 years of clinical nursing **Certifications and Licensures:** + Required RN ( Registered Nurse ) + Preferred ACM (Case Management) + Preferred ... trust, dignity, respect, responsibility and clinical excellence. **The Team Lead Utilization Review responsibilities include:** + Directing and coordinating the… more
- CenterWell (Tallahassee, FL)
- …community and help us put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual 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 focuses on excellent… more
- Molina Healthcare (Orlando, FL)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... (Team will work on set schedule) Looking for a RN with experience with appeals, claims review ,...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Tampa, FL)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... unit (ICU) or emergency room. Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG… more
- AdventHealth (Orange City, FL)
- …and experience you'll need to succeed:** **Minimum qualifications** : + Associate's degree Nursing or RN Diploma degree. + Registered Nurse ( RN ) State ... 1055 SAXON BLVD, Orange City, 32763 **The role you'll contribute:** The RN Care Manager, in collaboration with the patient/family, social workers, nurses, physicians… more
- Molina Healthcare (Orlando, FL)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal...the specific programs supported by the plan such as utilization review , medical claims review ,… more