- CVS Health (Tallahassee, FL)
- …Must have active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include ... med surg or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing in EST or CST zones.… 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
- CVS Health (Tallahassee, FL)
- …constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications + Registered Nurse in state of ... years of Nursing experience. Preferred Qualifications + Prior authorization utilization management /review experience preferred Outpatient Clinical experience. +… more
- Lincoln Financial (Tallahassee, FL)
- …Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible ... for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state...Care, , Trauma , Disability, Workman's comp or case management or Utilization review **Application Deadline** **What's… more
- MyFlorida (Orlando, FL)
- …Bachelor's Degree in any other discipline with at least 6 months of direct case management experience or a Florida Licensed Registered Nurse (RN) with 1-year of ... HUMAN SERVICES PROGRAM CONSULTANT II - 64006362 Date: May 6, 2025...(CBO's). Incumbent reports directly to the Supervisor of Case Management . Staff will establish and maintain a caseload of… more
- MyFlorida (Tallahassee, FL)
- REGISTERED NURSING CONSULTANT - 64064600 Date: Apr 26, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... 847535 Agency: Department of Health Working Title: REGISTERED NURSING CONSULTANT - 64064600 Pay Plan: Career Service Position Number:...This position will join a group of other Registered Nurse Consultants with the NBS Nursing Unit. The ability… more
- Highmark Health (Tallahassee, FL)
- … **SKILLS** + Deep Clincal Expertise -extensive knowledge of clinical, quality, care, utilization , high-cost claim, and population health management . Must be a ... in Business or Clinical field **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse (RN) or Pharmacist (Pharm D) or Physician Assistant (PA) **Preferred** +… more
- Centene Corporation (Tallahassee, FL)
- …abuse across the continuum of care. Experience with managed care, case management , utilization management , or quality improvement. **License/Certification:** ... staff, provider and member satisfaction + Serve as resource and liaison on utilization , quality improvement and case management activities + Performs other… more
- Cleveland Clinic (Port Saint Lucie, FL)
- …compliance with all standards and favorable performance on safety, quality, utilization and experience metrics. + Participate in engraining the safety, quality ... data and participate in improvement strategy development. + Act as a consultant in educating and evaluating clinical and support department caregivers regarding… more
- Trinity Health (Fort Lauderdale, FL)
- …with members of the interprofessional acute care, ambulatory and post-acute care management teams to improve communication across the continuum of care. * ... that have been documented in the medical record. * Serves as a consultant and educator with medical staff regarding status, placement, payer requirements, and … more
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