- Humana (Tallahassee, FL)
- …to HCA St. Lucie Medical Center, in Palm Beach County, from home base. The Utilization Management Nurse 2 is an Onsite Nurse located at HCA St. Lucie ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes...to Member + Follows established guidelines/procedures This is an Onsite / Hybrid position at HCA St. Lucie Medical… more
- BayCare Health System (Tampa, FL)
- …Occasional + **On Call:** No **Certifications and Licensures:** + Required RN (Registered Nurse ) + Preferred ACM (Case Management ) + Preferred CCM (Case Manager) ... Required 2 years in Utilization Review or + Required 2 years in Case Management or + Required 3 years Registered Nurse + Preferred experience in Critical… more
- ChenMed (St. Petersburg, FL)
- … management programs, clinical meetings and other meetings. The Nurse Practitioner, Specialty incumbent adheres to strict departmental goals/objectives, standards ... we need great people to join our team. The Nurse Practitioner (NP), Specialty acts as part of the...nursing plan of care, health education, physician referrals, case management referrals, follow-up and clear documentation according to ChenMed… more
- Elevance Health (FL)
- …in an ambulatory or hospital setting or minimum of 1 year of prior utilization management , medical management and/or quality management , and/or ... ** Nurse Reviewer I** **Location:** This role enables associates...required. **Preferred Experience, Skills, and Capabilities:** + Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding,… more
- ChenMed (Bradenton, FL)
- … management programs, clinical meetings and other meetings. The Nurse Practitioner will adhere to strict departmental goals/objectives, standards of performance, ... we need great people to join our team. The Nurse Practitioner (NP) acts as part of the clinical...nursing plan of care, health education, physician referrals, case management referrals, follow-up and clear documentation according to ChenMed… more
- ERP International (Hurlburt Field, FL)
- …algorithms, CM software, and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case management with ... **Overview** ERP International is seeking a full time **Registered Nurse (RN) Case Manager** in support of the 1st Special Operations Medical Group at Hurlburt… more
- Evolent (Tallahassee, FL)
- …Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed ... medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care across the continuum… more
- Elevance Health (Tampa, FL)
- …solving with providers, claims or service issues. + Assists with development of utilization /care management policies and procedures. + Within the medical ... **Transplant Nurse II** **Location:** Virtual: This role enables associates...II** will be responsible for providing case and/or medical management for members receiving transplant services. Continue to learn… more
- Elevance Health (Tampa, FL)
- …the criteria._** The ** Nurse Case Manager II** is responsible for care management within the scope of licensures for members with complex and chronic care needs ... ** Nurse Case Manager II** **Location** : This role...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- Elevance Health (Tampa, FL)
- …to 8:00 PM EST. The ** Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care needs by ... ** Nurse Case Manager II** **Location:** This role enables...providers, claims or service issues. Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more