- Actalent (Sunrise, FL)
- Actalent is hiring a Utilization Management Nurse ! Job Description The Utilization Management Nurse (UMN) collaborates closely with the ... activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management + InterQual + Milliman Commercial Guidelines… more
- CVS Health (Tallahassee, FL)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and knowledge in ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
- CVS Health (Tallahassee, FL)
- …Must be willing and able to work Monday through Friday, 8:00am to 5:00pm. Utilization management is a 24/7 operation. Work schedules will include weekend/holiday ... zone + 3+ years of experience as a Registered Nurse + 3+ years of clinical experience required +...+ Managed Care experience + Discharge planning experience + Utilization Management experience **Education** Associates Degree or… more
- Actalent (Sunrise, FL)
- Utilization Management Nurse !Job Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing service authorization ... activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management + Interqual + Milliman Commercial Guidelines… more
- AdventHealth (Tampa, FL)
- …as heart failure, cancer and other diseases. **The role youll contribute:** The Utilization Management RN Supervisor reports directly to the Divisional ... Utilization Management RN Manager and assists in monitoring and performing...succeed** **:** + Associates degree in nursing + Registered Nurse (RN) license + 3 years of experience of… more
- Elevance Health (Miami, FL)
- ** Utilization Management Representative II** **Location:** This role enables associates to work virtually full-time in **Florida** , with the exception of ... 6 am - 6 pm EST including weekends. The ** Utilization Management Representative II** is responsible for...given. + Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care. +… more
- Elevance Health (Miami, FL)
- ** Utilization Management Representative II** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... an accommodation is granted as required by law._ The ** Utilization Management Representative II** is responsible for...given. + Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care. +… 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
- Baylor Scott & White Health (Tallahassee, FL)
- …to fit their needs. + Proficiency in discharge planning, setting case management referral standards, reviewing utilization , and categorizing levels of care. ... on position type and/or level **Job Summary** As the Utilization Review RN you will review patient cases for...issues or trends impacting specific entities to the appropriate management is expected. + Part of your work will… more
- Sharecare (Tallahassee, FL)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
Recent Searches
- Clinical Psychologist Licensed Sharp (United States)
- Software Development Engineer II (Washington)
- Filter Media Engineer (United States)
- Senior Signals Software Engineer (Washington, DC)
Recent Jobs
-
Lead Person Shipping (2nd Shift)
- Whirlpool Corporation (Sturtevant, WI)
-
Guest Room Attendant
- Golden Route Operations (Laughlin, NV)
-
Sr. Mobile Application Developer
- Two95 International Inc. (Scottsdale, AZ)
-
Stocking Associate
- Crate & Barrel (Chamblee, GA)