- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CVS Health (Tallahassee, FL)
- …more personal, convenient and affordable. **Position Summary** This is a fulltime remote Utilization Management Clinical Consultant opportunity for ... to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking...+ Licensed Independent Behavioral Health clinician or an unrestricted Registered Nurse ( RN ) license in… more
- Sharecare (Tallahassee, FL)
- …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The RN is also responsible for ... and their Primary Care Provider according to the disease management program intervention guidelines. An RN is...the disease management program intervention guidelines. An RN is supervised by an Operations Manager (OM). All… more
- CVS Health (Tallahassee, FL)
- …members sign up to work one major and one minor holiday yearly. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, ... health care more personal, convenient and affordable. **Position Summary:** Utilization Management is a 24/7 operation and...**Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current… more
- CVS Health (Tallahassee, FL)
- …convenient and affordable. **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote and the candidate must live in ... 1 per month.** No travel is required. As a Utilization Management Nurse Consultant, you...the coordination and administration of the utilization /benefit management function. **Required Qualifications:** + RN with… more
- Highmark Health (Tallahassee, FL)
- …Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of health care ... depending on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field **SKILLS** + Working knowledge of… more
- Guardian Life (Tallahassee, FL)
- …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...plan and length of disability. Plan for ongoing case management through proactive partnering with treating providers to move… more
- Highmark Health (Tallahassee, FL)
- … - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health care ... Experience in a clinical setting **Preferred** + Certification in utilization management or a related field +...and Family Therapist (LMFT) + Licensed Behavior Specialist + Registered Nurse . **Preferred** + None **SKILLS** +… more
- Centene Corporation (Tallahassee, FL)
- …and Family Therapist (LMFT) required or Licensed Mental Health Professional (LMHP) required or RN - Registered Nurse - State Licensure and/or Compact State ... Complies with all policies and standards **_This is a remote position available for candidates located in FL. The...the continuum of care. Experience with managed care, case management , utilization management , or quality… more