- BayCare Health System (Tampa, FL)
- …appraisals + Community discounts and more Equal Opportunity Employer Veterans/Disabled **Position** Utilization Review RN **Location** Tampa:St Josephs | ... of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/ RN responsibilities...+ **On Call:** No **Certifications and Licensures:** + Required RN ( Registered Nurse ) + Preferred… more
- Molina Healthcare (St. Petersburg, 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
- Molina Healthcare (St. Petersburg, 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
- CenterWell (Tampa, FL)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- BayCare Health System (Bradenton, FL)
- …care goals. + Knowledge of regulatory standards appropriate to position. **Requirements:** + RN ( Registered Nurse ) License + Driver's License, State of ... Career with BayCare HomeCare as a Home Care Supervisor, RN ! At BayCare, we are proud to be one...area of responsibility. + Ensure quality assurance program and utilization review is followed in accordance with… more
- BayCare Health System (Dunedin, FL)
- …with 1 year Home Health RN visit experience. **Required Credentials:** + RN ( Registered Nurse ) License + Diploma, Associate's or Bachelor's Nursing ... regulatory bodies within the area of responsibility + Ensure quality assurance program and utilization review is followed in accordance with Home Care protocol +… more
- HCA Healthcare (St. Petersburg, FL)
- …Hospital we support our colleagues in their positions. Join our Team as a(an) Registered Nurse Service Line Coordinator OR and access programs to assist with ... gain certifications and job skills. Apply today for our Registered Nurse Service Line Coordinator OR opening...satisfaction for your patients. + You will ensure effective utilization of resources, standards of care, and operating procedures.… more
- HCA Healthcare (Largo, FL)
- …do. We want you to apply! **Job Summary and Qualifications** **We are seeking a Registered Nurse Case Manager. You will provide clinical expertise to ensure all ... promote cost effectiveness through the integration of case management, utilization review management and discharge planning.** **What...we encourage you to apply for our Case Manager RN opening. We promptly review all applications.… more
- HCA Healthcare (Sun City Center, FL)
- …Healthcare Quality) OR CHCQM (Diploma in American Board of Quality Assurance and Utilization Review Physicians). _Individuals without CPHQ or_ CHCQM _will be ... As our Director, you willprovide direction to ensure the facilitation and utilization of diverse strategies and communication for quality and performance improvement… more
- HealthTrust Workforce Solutions (Bradenton, FL)
- …nationwide. **_JOB SUMMARY_** The Interim Leader of Case Management Services is a Registered Nurse who participates as an active administrative member of the ... to assure that the following functions of the role are completed: Utilization Review for medical necessity of admission and concurrent stay, Social Services… more
- Battelle Memorial Institute (Tampa, FL)
- …two years' nursing experience + Current, full, active, and unrestricted license as a Registered Nurse in any US State, the District of Columbia, Guam, Puerto ... (HRA) business line is seeking a highly motivated, full-time ** Nurse Case Manager** to join our team in support...professional parameters + Knowledge and skill in using pre-established utilization review criteria to recognize and report… more
- Deloitte (Tampa, FL)
- …Bachelor's degree in nursing, medical degree, or physician assistant required + Current Registered Nurse ( RN ) license required + Certified Clinical ... nurse , physician, physician assistant, case manager, clinical documentation specialist, utilization review , informatics RN , Quality, DRG Validation and… more
- Elevance Health (Tampa, FL)
- …moderately complex case types that do not require the training or skill of a registered nurse . **Primary duties may include but are not limited to:** + ... **Medical Management Clinician** - Licensed Nurse **Locations:** Tampa, FL **Hybrid 1** : This...a minimum of 4 years of clinical experience and/or utilization review experience. Current active, valid and… more
- Elevance Health (Tampa, FL)
- …or case management experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or any combination of education ... include every weekend (Saturday and Sunday). The **Medical Management Nurse ** will be responsible for review of...Capabilities, and Experiences:** + Current active, valid and unrestricted RN license and/or certification to practice as a health… more
- Molina Healthcare (St. Petersburg, FL)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... (Team will work on set schedule) Looking for a RN with experience with appeals, claims review ,...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- HCA Healthcare (Tampa, FL)
- …and personal growth, we encourage you to apply for our Operating Room RN opening. We promptly review all applications. Highly qualified candidates will ... like family! Jump-start your career as an Operating Room RN today with Tampa Eye Surgery Center. **Benefits** Tampa...Summary and Qualifications** We are seeking an Operating Room Nurse for our ambulatory surgery center who demonstrates the… more
- HCA Healthcare (Largo, FL)
- …verbal instructions, PC skills **What qualifications you will need:** + Bachelors Degree + ( RN ) Registered Nurse , or (OT) Occupational Therapist, or (LPT) ... meeting commitments to referral sources. Develops a call-plan to prioritize utilization of time. + Completes face-to-face, in-service educational contacts with… more
- Elevance Health (Tampa, FL)
- …center The **Manager Behavioral Health Services** is responsible for Behavioral Health Utilization Management (BH UM), or Behavioral Health Case Management (BH CM) ... assist with implementation of cost of care initiatives. + May attend meetings to review UM and/or CM process and discusses facility issues. + Hires, trains, coaches,… more
- Elevance Health (Tampa, FL)
- **Telephonic Nurse Case Manager II** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... the assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of… more
- ChenMed (Bradenton, FL)
- …explain nurse practitioner role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... 50-75% of local travel **EDUCATION AND EXPERIENCE CRITERIA:** + Current RN licensure and Nurse Practitioner Certification in the State of practice required +… more