- Cognizant (Tallahassee, FL)
- …need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...clinic operations . Experience in utilization management to include Clinical Appeals and Grievances, precertification, initial and… more
- Molina Healthcare (Tampa, FL)
- …resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries/ Appeals . + Provides training and support to clinical ... (Team will work on set schedule) Looking for a RN with experience with appeals , claims review, and medical coding. **Job Summary** Utilizing clinical knowledge… more
- CVS Health (FL)
- …licensure in non-compact states as needed. + 5+ years of acute experience as a Registered Nurse + 3+ years of Utilization Management experience + 3+ year(s) of ... and other key stakeholders such as Medical Directors, account teams/ clinical liaisons, etc.) to ensure consistency in clinical... Appeals experience in Utilization Management + Must have experience… more
- AdventHealth (Altamonte Springs, FL)
- …role you will contribute:** The role of the Utilization Management (UM) Registered Nurse (RN) is to use clinical expertise by analyzing patient records to ... appropriate level of care. The UM RN utilizes key clinical data points to assist in status and level...expertise and experiences you'll need to succeed:** RN - Registered Nurse - State Licensure and/or Compact… more
- AdventHealth (Orlando, FL)
- …of professional nursing theory and practice to give and evaluate patient care. The Registered Nurse (RN) is responsible for providing and supervising direct and ... caring for:** + More than 800 physicians, 450 advanced practice providers, and 2,600 clinical and support staff in over 40 specialties, provide patients with a broad… more