- CVS Health (Tallahassee, FL)
- …And we do it all with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior Authorization** ... internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and… more
- AdventHealth (Altamonte Springs, FL)
- …**Job Location** : Remote **The role you will contribute:** The Utilization Management nurse uses clinical expertise to review for medical necessity ... other related software and databases to perform required actions that encompass Utilization Management . Demonstrates strong analytical, problem solves skills and… more
- Humana (Tallahassee, FL)
- …help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Cognizant (Tallahassee, FL)
- …. Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical … more
- Humana (Tallahassee, FL)
- …of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent… more
- CVS Health (Tallahassee, FL)
- … (UM) Nurse Consultant. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate all ... and state regulated turn-around times. This includes reviewing written clinical records. **Key Responsibilities of the UM Nurse...practice experience as an RN required. + 2+ Years Utilization Management experience. + Must be willing… more
- Actalent (Sunrise, FL)
- … Utilization Review Nurse Job Description We are seeking a dedicated Utilization Management Nurse (UMN) who will work collaboratively with an ... reports on department activities as assigned. Essential Skills + Utilization management + Behavioral Health + Mental...management + Behavioral Health + Mental Health + Clinical review + Utilization review Additional Skills… more
- CVS Health (Tallahassee, FL)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
- Centene Corporation (Tallahassee, FL)
- …LMFT, or LMHP.** **Position Purpose:** Leads and directs the behavioral health (BH) utilization management team to ensure appropriate member care. . Ensures ... changes everything for our 28 million members as a clinical professional on our Medical Management /Health Services...of policies, procedures, and processes. Leads and develops BH utilization management strategies and objectives within … more
- CVS Health (Tallahassee, FL)
- … skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable in ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years post… more