- Healthfirst (FL)
- **Duties/Responsibilities:** + Oversees utilization management functions which include timely authorizations related to pre-certification, concurrent review, ... and reviews medical charts to obtain additional information required for appropriate utilization management and to solve complex clinical problems + Allocate,… more
- 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 ... Working under the general supervision of the Director and/or Manager /Supervisor of Medical Management , and in collaboration...on department activities. Essential Skills + Clinical review + Utilization review + Utilization management … more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …safe discharge coverage for all hospital units. + Participates in utilization management initiatives/opportunities for improvement through departmental committee ... the State of Florida. + 3 years minimum experience in discharge planning, utilization management , or case management . + Basic proficiency in Microsoft Word,… more
- Ascension Health (Pensacola, FL)
- …salary range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes ... **Details** + **Department: Utilization Review** + **Schedule: Full time days** +...utilization criteria, appeal and review process, and case management system documentation. + Conduct hiring, training, directing, development… 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
- CenterWell (Tallahassee, FL)
- …UM Administration Coordinator - Phone Intake contributes to administration of utilization management . The UM Administration Coordinator performs varied ... service or customer service telephone experience desired + Experience with Utilization Review and/or Prior Authorization, preferably within a managed care… more
- Select Medical (Panama City, FL)
- …by doing what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning, treatment plan management ... **Overview** **Critical Illness Recovery Hospital** **Case Manager (PRN)** _Requires a current licensure in a...the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates… more
- CenterWell (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Manager Care/Case Management in **Palm Beach/TC area** is responsible for managing a ... for managing populations and coordinating care to reduce acute and post-acute care utilization . The Manager role is hybrid with travel requirements to preferred… more
- ChenMed (North Miami Beach, FL)
- …years' clinical work experience required. + A minimum of 1 year of utilization review and/or case management , home health, hospital discharge planning experience ... post-acute facilities, as well as, their home environments. The Nurse Case Manager 1 (RN) role also involves establishing relationships with patients' families and… more
- Grifols Shared Services North America, Inc (Orlando, FL)
- …specified "Account List" of Health Systems designed to increase the adoption and utilization of the Grifols Bleeding Management product portfolio. The KAM's ... countries and regions. **Role and Responsibilities of a Bleeding Management KAM** **About the Role:** The KAM will play...provide any necessary support to the responsible National Account Manager (NAM) in the execution of the contracting process… more