- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to ... independent determination of the appropriate courses of action. The Utilization Management Registered Nurse...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- Baylor Scott & White Health (Tallahassee, FL)
- …and members. **Key Success Factors** + Demonstrable knowledge in discharge planning, case management , utilization review and different care levels. + ... type and/or level **Job Summary** As a Manager for Utilization Review , you guide and supervise staff....work experience + Hold a valid registration as a Registered Nurse As a health care system… more
- CVS Health (Tallahassee, FL)
- …through Friday 8:00am - 5:00pm in time zone of residence **Preferred Qualifications** - Utilization Management review - Managed Care experience - Client ... experience required - 2+ years of experience as a Registered Nurse - Must have active current...Nurse - Must have active current and unrestricted RN licensure in state of residence - 1+ years… more
- MTC (Quincy, FL)
- …record or other forms as appropriate. + Practice basic cost containment and utilization management for inmate care and facility operations. + Maintain absolute ... in one package!** Are you a dedicated and skilled RN looking for a meaningful opportunity to provide exceptional...HIPAA rules. + Accurately and promptly chart medical care. Review medical files to determine all provided services are… more
- MyFlorida (Chattahoochee, FL)
- REGISTERED NURSE SPECIALIST - F/C -...dynamics. This position with APD will serve staff and management across the Agency. Your work will impact the ... 837602 Agency: Agency for Persons with Disabilities Working Title: REGISTERED NURSE SPECIALIST - F/C - 67056731...as a member of the DDDP Behavior Analysis Local Review Committee, Support Planning Committee, and treatment team. Performs… more
- MyFlorida (Chattahoochee, FL)
- REGISTERED NURSE SPECIALIST-F/C OPS - 60953707 Date: Dec 30, 2024 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... Requisition No: 843873 Agency: Children and Families Working Title: REGISTERED NURSE SPECIALIST-F/C OPS - 60953707 Pay...knowledgeable of and utilize the principles of Total Quality Management . Nursing will provide guidance in the care and… more
- Highmark Health (Tallahassee, FL)
- …and Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management review processes that are consistent with established… 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...orientation and to take the pre and posttests to review competency during orientation. Yearly competency test is required… more
- Highmark Health (Tallahassee, FL)
- …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES:** + Implement care management review processes that are consistent with established… more
- CVS Health (Tallahassee, FL)
- …Must reside in Florida + Licensed Independent Behavioral Health clinician or an unrestricted Registered Nurse ( RN ) license in FL with psychiatric specialty ... convenient and affordable. **Position Summary** This is a fulltime remote Utilization Management Clinical Consultant opportunity for candidates residing in… more
- CVS Health (Tallahassee, FL)
- …of Saturday shift is approximately 1 per month.** No travel is required. As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... to make health care more personal, convenient and affordable. **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote… more
- Humana (Tallahassee, FL)
- …providers or members **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in either Florida or a compact state ... us put health first** Job Description Summary The Pre-Authorization Nurse 2 reviews prior authorization requests for appropriate care...+ 2 or more years of Utilization Management (UM), Pre-Auth, and/or other managed care review… 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...issues, when possible, to enhance the customer experience. **Activity** Review and assess claimant subjective reports and objective medical… more
- HCA Healthcare (Tallahassee, FL)
- …options and costs to patient and patient families. **What qualifications you will need:** + Registered Nurse , or Advance Practice Registered Nurse (APRN) ... in your career path, we encourage you to apply for our Manager Case Management opening. We review all applications. Qualified candidates will be contacted by… 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 ... providers regarding clinical information from the Operations and Medical Management teams. Assesses and performs review of...the continuum of care. Experience with managed care, case management , utilization management , or quality… more
- MyFlorida (Tallahassee, FL)
- …Estimator Tool (https://compcalculator.myflorida.com/) AGENCY FOR PERSONS WITH DISABILITIES POSITION: Registered Nurse Consultant - Career Service WORKING TITLE: ... vendors and agency staff to provide consultation for ICF/IID utilization review and Group Home Medical ...Registered Nursing license is required. Licensure as a Registered Professional Nurse in accordance with Florida… more
- HCA Healthcare (Tallahassee, FL)
- …and personal growth, we encourage you to apply for our Operating Room Nurse PRN-Surgery Center opening. We review all applications. Qualified candidates will ... have the PRN career opportunities as an Operating Room Nurse PRN-Surgery Center you want with your current employer?...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… more
- HCA Healthcare (Tallahassee, FL)
- …Center have the opportunity to make a real impact. As an Operating Room Nurse - Surgery Center you can be a part of change. **Benefits** Tallahassee Outpatient ... location._** It is an exciting time to be a nurse at HCA Healthcare! Come unlock your career potential...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… more