- Veterans Affairs, Veterans Health Administration (Winter Park, FL)
- …throughout the continuum of care. Responsibilities The Community Care (CC) Utilization Review Registered Nurse ( RN ) is responsible for collecting, ... reviewing and care coordination for the VAHCS. The CC Utilization Review RN performs a...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- HCA Healthcare (Panama City, FL)
- **Description** **Introduction** Do you have the career opportunities as a Utilization Review Services RN you want with your current employer? We have an ... of colleagues. Do you want to work as a Utilization Review Services RN...- 4 years of relevant case management/ utilization review experience preferred + Registered Nurse… more
- Centene Corporation (Tallahassee, FL)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... Analyzes BH member data to improve quality and appropriate utilization of services + Provides education to...abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with… more
- Centene Corporation (Tallahassee, FL)
- …to review and/or assess ABA Treatment Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with ... Analyzes BH member data to improve quality and appropriate utilization of services + Interacts with BH...+ Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse -… more
- Trinity Health (Fort Lauderdale, FL)
- …Care Plans to ensure authorization for hospital stay. Hybrid Position **_Position Purpose:_** ** Utilization Review (UR) Nurses play a vital role in healthcare by ... hospital clinical experience is required.** Recent experience in case management, utilization review , discharge planning, ongoing monitoring and evaluation of… more
- CVS Health (Tallahassee, FL)
- …without personal distractions to meet quality and metric expectations. **Required Qualifications** + Registered Nurse ( RN ) - active license. + 3+ Years ... of clinical experience. + 1+ Year of Utilization Review Management and/or Medical Management experience. + Must have active and unrestricted RN license in… more
- Community Health Systems (Naples, FL)
- …meet deadlines. + Effective written and verbal communication skills. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact ... **Job Summary** Under the direction of the UR Director/Manager the UR Nurse reviews all admissions for medical necessity, correct orders based on medical condition… more
- Actalent (Sunrise, FL)
- …team to perform reviews of service authorization requests, ensuring the utilization of appropriate services . The UMN assists in complex cases, develops ... Actalent is hiring a Utilization Management Nurse ! Job Description The...internal processes, and educates physicians on utilization review issues. The role involves managing… more
- CVS Health (Tallahassee, FL)
- …to promote quality effectiveness of healthcare services and benefit utilization . **Required Qualifications** + Active and unrestricted RN licensure in ... care **Preferred Qualifications** + NICU experience highly preferred + Managed care/ utilization review experience + Ability to multitask, prioritize and… more
- Molina Healthcare (FL)
- …and Monitoring team responsible for prior authorizations, inpatient/outpatient medical necessity/ utilization review , and/or other utilization management ... Monitoring statistics including plan utilization , staff productivity, cost effective utilization of services , management of targeted member population, and… more