- Humana (Tallahassee, FL)
- …an impact** **Use your skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the (appropriate state) with no ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing...in an acute care setting + Previous experience in utilization management/ utilization review for a… more
- Molina Healthcare (FL)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... emergency room. Preferred Experience Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual /… more
- Actalent (Miami, FL)
- …complete cases. Qualifications: + 3+ years of utilization management, concurrent review , prior authorization, utilization review , case management, and ... Urgent Hiring for "Remote Clinical Review Nurses" Job Description: + Review ...discharge planning is must + Active RN Compact License is Must If you are Interested… more
- CVS Health (Tallahassee, FL)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- Adecco US, Inc. (Tallahassee, FL)
- …basis **Position Overview** A large acute care hospital is seeking an experienced ** Registered Nurse Case Manager** to join its Case Management team. This ... **Position Title:** Case Manager RN **Location:** Tallahassee, FL 32310 **Position Type:** Nursing...if current and compliant + Case Management, Nursing, or Utilization Review certification preferred **Benefits** + Comprehensive… more
- Molina Healthcare (Miami, FL)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The RN Clinical Appeals Nurse provides support... licensure, Diagnosis-Related Group (DRG) experience, 2 years of Utilization Review and/or Medical Claims Review… more
- HCA Healthcare (Tallahassee, FL)
- …active FL RN license required within90 days of hire** + **Advanced Practice Registered Nurse license is acceptable for position if current and compliant** + ... supporting a balance of optimal care and appropriate resource utilization . The RN CM Care Coordinator will...**Certification in Case Management, Nursing, or Utilization Review , preferred** + **Three years of… more
- Community Health Systems (Naples, FL)
- …platforms, healthcare software systems, and data analysis tools. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact ... for the planning, coordination, and oversight of care management services, including utilization review , discharge planning, and transitions of care. The role… more
- HCA Healthcare (Tallahassee, FL)
- …active FL RN licenserequiredwithin90 days of hire** + **Advanced Practice Registered Nurse license is acceptable for position if current and compliant** ... supporting a balance of optimal care and appropriate resource utilization . The RN CM Care Coordinator will...+ **Certification in Case Management, Nursing, or Utilization Review , preferred** + **Three years of… more
- HCA Healthcare (Tallahassee, FL)
- …FL RN license required within 90 days of hire** + **Advanced Practice Registered Nurse license is acceptable for position if current and compliant** + ... supporting a balance of optimal care and appropriate resource utilization . The RN CM Care Coordinator will...**Certification in Case Management, Nursing, or Utilization Review , preferred** + **Three years of… more