- Humana (Tallahassee, FL)
- …and programs **Use your skills to make an impact** **Required Qualifications** + Registered nurse ( RN ) with unrestricted licensed **OR** independent licensed ... of our caring community and help us put health first** The Utilization Management (UM) Director, Clinical Strategy and Practice for Medicaid builds strategies… more
- CVS Health (Tallahassee, FL)
- …active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include weekends, ... **Required Qualifications** + 2+ years of experience as a Registered Nurse in adult acute care/critical care...or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing… more
- AdventHealth (Orlando, FL)
- …**The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse ( RN ) is to use clinical expertise by analyzing patient ... and valid license to practice in Florida as a Registered Nurse (ADN or BSN) required. +...care clinical nursing experience required. + Minimum two years Utilization Management experience, or equivalent professional experience.… more
- Humana (Tallahassee, FL)
- …part of our caring community and help us put health first** The SNF Utilization Management Nurse uses clinical knowledge, communication skills, and ... where needed. Follows established guidelines and procedures. The SNF Utilization Management Nurse uses clinical...an impact** **Required Qualifications** + Compact licensure + Licensed Registered Nurse ( RN ) in the… more
- CVS Health (Tallahassee, FL)
- …administration of the utilization /benefit management function. Required Qualifications + Registered Nurse in state of residence. + 3+ years of Nursing ... experience. Preferred Qualifications + Prior authorization utilization management /review experience preferred Outpatient Clinical experience. + Knowledge of… more
- Veterans Affairs, Veterans Health Administration (Gainesville, FL)
- Summary The Utilization Management (UM) Registered Nurse ( RN ) is responsible for UM reviews for patients who receive hospital care. Responsibilities ... An UM Registered Nurse is responsible for UM reviews...accreditation standards, and performance measures. Uses emergency and bed management software and utilization data to manage… more
- Ascension Health (Pensacola, FL)
- …and coordinate compliance to federally mandated and third party payer utilization management rules and regulations. **Requirements** Licensure / Certification ... offer._ **Responsibilities** Provide health care services regarding admissions, case management , discharge planning and utilization review. +.../ Registration: + Licensed Registered Nurse credentialed from the Florida Board… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …safe discharge coverage for all hospital units. + Participates in utilization management initiatives/opportunities for improvement through departmental committee ... assignments. Qualifications: + Registered Nurse or Licensed Practical Nurse...Florida. + 3 years minimum experience in discharge planning, utilization management , or case management .… more
- Ascension Health (Pensacola, FL)
- …evaluation of staff. **Requirements** Licensure / Certification / Registration: + Licensed Registered Nurse credentialed from the Florida Department of Health ... salary range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes… more
- AdventHealth (Altamonte Springs, FL)
- …documents avoidable days, and facilitates progression of care. Collaborates with Utilization Management staff for collaboration on patient status changes ... valid State of Florida or multistate license as a Registered Nurse + 2 years of medical/...+ Health-related master's degree or MSN + Prior Care Management / Utilization Management experience +… more