- Elevance Health (Miami, FL)
- RN Utilization Management Nurse Sr. (Medicaid-InPatient) JR130851 **Location:** Must be within 50 miles / 1 hour commute of Tampa or Miami, FL offices. ... Friday. **2 Holidays** per year and **occasional** weekends. The ** Nurse Medical Management Sr** serves as T...Requires minimum of 5 years acute care clinical experience, utilization management or managed care experience; or… more
- Fresenius Medical Center (Miami, FL)
- …under the direction of the Facility Manager, Director of Nursing and/or Charge Registered Nurse , utilizing standard nursing techniques to assist the physician in ... on adverse events and action thresholds in collaboration with facility management . + Maintains integrity of medical records and other organization administrative… more
- University of Miami (Miami, FL)
- …of Case Management . + Incorporates the fundamental principles of utilization management , monitoring resource consumption, social services intervention and ... University of Miami/UHealth has an exciting opportunity for an RN Case Manager in the Case Management ...and community services to patients and families through effective utilization of available resources. + Manages the observation patients… more
- HCA Healthcare (Miami, FL)
- …reservations or limits? Our HCA Florida Kendall Hospital team is looking for a RN Nurse Manager Med Surg. HCA Healthcare is an advanced healthcare network ... save lives across the country? Apply today to our RN Nurse Manager Med Surg and be...qualifications you will need:** + Current Florida license as Registered Nurse or Recognized Compact Licensure (subject… more
- Molina Healthcare (Doral, FL)
- **_For this position we are seeking a ( RN ) Registered Nurse with previous experience in Hospital Acute Care, Concurrent Review/ Utilization Review / ... Medical, or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina… more
- KBR (Homestead, FL)
- …a clearance. + Current RN license; full, active, and unrestricted license as a Registered Nurse in one of any US State, the District of Columbia, Guam, ... organization (ie Commission for Case Management Certification, American Case Management Association or American Nurse Credentialing Center) or shall obtain… more
- KBR (Homestead AFB, FL)
- …+ Current RN license ; full , active, and unrestricted license as a Registered Nurse in one of any US State, the District of Columbia, Guam, Puerto ... a case manager by a recognized certifying organization, ie Commission for Case Management Certification or America n Nurse Credentialing Center. + Demonstrated… more
- Elevance Health (Miami, FL)
- ** RN Hospital Bill Audit/Appeal Lead** **Supports the Carelon Payment Integrity line of business** _Location: This position will work a hybrid model (remote and ... is determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** RN Hospital Audit/Appeal Lead** is responsible for leading a team of… more
- Elevance Health (Miami, FL)
- …management plan and modifies as necessary. + Assists with development of utilization /care management policies and procedures. + Participates in or leads ... The Nurse Care Mgr II is responsible for collaborating...with healthcare providers and/or consumer to drive personalized health management and improve health outcomes for optimal consumers. Performs… more
- Elevance Health (Miami, FL)
- **Telephonic Nurse Disease Management II** **$2000 Sign on Bonus** At **Federal Health Products and Services - FHPS** , a proud member of the Elevance Health, ... pm, or 2:30 pm - 11 pm EST.** The **Telephonic** **N** **urse Disease Management II** will be responsible for telephonic outreach, enrollment, and management of… more
- Select Medical (Miami, FL)
- …of acute transfers and other CQI indicators. **Qualifications** **Minimum Qualifications** + Registered Nurse with valid state license. Legacy employees may ... **Location: Miami, FL** **$10,000 Sign-on Bonus** **Director of Quality Management ** **(DQM)** **Responsibilities** **Position Summary** Coordinates the Medical Quality… more
- University of Miami (Doral, FL)
- …CORE QUALIFICATIONS Education: Bachelor of Science in nursing Certification and Licensing: Registered nurse license Experience: Minimum 5 years of relevant ... FUNCTIONS Creates and assesses the daily schedule to plan optimal staff utilization and functioning of the operative schedule. Maintains effective lines of… more