- Prime Therapeutics (Tallahassee, FL)
- …Patient Programs. **Education & Experience** + Associates - Nursing + Bachelors - Nursing + RN - Registered Nurse , State and/or Compact State Licensure - ... for work visa or residency sponsorship. **Additional Qualifications** + Registered Nurse ( RN ). + 5...Experience in managed care, specialty drugs, care management and utilization review . + Meets Credentialing criteria. +… more
- Evolent (Tallahassee, FL)
- …quality and cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on ... + Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current,… more
- Houston Methodist (FL)
- …- One year of clinical experience preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or Compact ... an acute care hospital setting is required; coding and utilization review experience preferred + For Medical...State Licensure within 60 days **OR** + RN -Temp - Registered Nurse -… more
- HCA Healthcare (Sun City Center, FL)
- …required in Nursing or Healthcare related field . Current Florida licensure as a Registered Nurse preferred _**If serving as facility's primary Risk Manager, VP ... Quality) OR CHCQM (Diplomate in American Board of Quality Assurance and Utilization Review Physicians) _Individuals without CPHQ or ABQUARP will be granted a 12… more
- HCA Healthcare (Davie, FL)
- …2 years of critical care experience + Certification in case management or utilization review preferred + InterQual experience preferred HCA Florida University ... Summary and Qualifications** **What qualifications you will need:** + RN with current state licensure; BSN preferred + Three...apply for our Mgr Case Mgmt opening. We promptly review all applications. Highly qualified candidates will be directly… more
- Elevance Health (Tampa, FL)
- …or case management experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or any combination of education ... 6pm EST and will include weekends. The **Medical Management Nurse ** will be responsible for review of...Capabilities, and Experiences:** + Current active, valid and unrestricted RN license and/or certification to practice as a health… more
- HCA Healthcare (Aventura, FL)
- …2 years of critical care experience + Certification in case management or utilization review preferred + InterQual experience preferred HCA Florida Aventura ... the Rehabilitation team. **What qualifications you will need:** + RN with current state licensure; BSN preferred + Three...to apply for our Case Mgr opening. We promptly review all applications. Highly qualified candidates will be contacted… more
- HCA Healthcare (Gainesville, FL)
- …guidelines. Participates in developing department goals and clinical programming. + Performs utilization review as assigned. + Helps with Process and Quality ... to give people a healthier tomorrow."- Jane Englebright, PhD, RN CENP, FAAN Senior Vice President and Chief Nursing...Mental Health Professional III Lic PRN opening. We promptly review all applications. Highly qualified candidates will be directly… more
- CVS Health (Tallahassee, FL)
- …demonstrated ability to make thorough, independent decisions using clinical judgement. + A Registered Nurse that must hold an unrestricted license in their state ... UM ( utilization management) experience within an **outpatient** setting, concurrent review or prior authorization. + 5 years of a variety clinical experience… more
- AdventHealth (Orlando, FL)
- …of experience in home health + 2 years of experience in management position. + Registered Nurse State Licensure and/or Compact State Licensure + Cert for Oasis ... **Population Health Case Manager ( RN ) AdventHealth Home Health** **All the benefits and...contribute:** The Population Health Case Manager (PHCM) ensures effective utilization and case management oversight activities as defined by… more