- Actalent (Sunrise, FL)
- Actalent is hiring UM nurses!Job Description The Utilization Management Nurse (UMN) plays a crucial role in optimizing the utilization of healthcare ... on department activities. Essential Skills + Clinical review + Utilization review + Utilization management ...medical record software Work Environment The role offers a hybrid work schedule post-training, with hours from Monday to… more
- Humana (Tallahassee, FL)
- …a part of our caring community and help us put health first** The Utilization Management (UM) Director, Clinical Strategy and Practice for Medicaid builds ... of how organization capabilities interrelate across the function or segment. The Utilization Management (UM) Director, Clinical Strategy and Practice for… more
- Elevance Health (Tampa, FL)
- ** Utilization Management Representative I** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person ... integration, and ensures essential face-to-face onboarding and skill development. The ** Utilization Management Representative I** will be responsible for… more
- Centene Corporation (Tallahassee, FL)
- …28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive ... Analyzes BH member data to improve quality and appropriate utilization of services + Provides education to providers members...Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required… more
- Elevance Health (Miami, FL)
- …required.** The **Telephonic Nurse Case Manager I** is responsible for care management within the scope of licensure for members with complex and chronic care ... **Telephonic Nurse Case Manager I** **Location:** This role enables...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum** **Requirements:**… more
- Elevance Health (FL)
- …nursing preferred. + Participation and/or certification in a managed care or utilization management organization preferred. + Ability to understand clinical ... and quality of life through home-care and community based services The **Triage Nurse I - Carebridge - Bilingual** is responsible for determining the appropriate… more
- Humana (Tallahassee, FL)
- …**Key Functions:** **Strategic Planning and Implementation:** + Develop and implement utilization management strategies that align with organizational goals. + ... care. **Cost Containment:** + Identify opportunities for cost savings through effective utilization management practices. + Monitor and analyze utilization … more
- Olympus Corporation of the Americas (Tampa, FL)
- …team. The primary responsibility of this role is to manage and enhance the utilization of our disposable energy line within our key regional hospitals. This position ... Duties** + Develop and execute strategies to increase the utilization of disposable products within our current hospital networks....Minimum of 1-4 years of Operating Room experience (tech, nurse , OR sales etc.). + Proven experience in a… more
- Grifols Shared Services North America, Inc (Clearwater, FL)
- …etc.). Build relationships in institutions aligned with customer segmentation. + Utilization of Managed Markets, Marketing, Ig Nurse Educators, MSL, ... requests and set up succeeding interaction points. The SSR will have a hybrid , rep-enabled capability and an omnichannel approach to respond to business customers,… more
- Elevance Health (Miami, FL)
- …and oversees program operations in support of corporate and health plan UM management . + Directs and collaborates with functional managers to develop and implement ... and monitors program schedule, budget, and resources plan. + Manages resource utilization to ensure appropriate delivery of care to members and adequate coverage… more
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