• RN Utilization Management

    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
    Elevance Health (10/01/24)
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  • Advanced Practice Registered Nurse

    University of Miami (Miami, FL)
    …sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Job Profile Name: Advanced Practice Registered Nurse FLSA Status: Ex e ... mpt CORE JOB SUMMARY 50% The Advanced Practice Registered Nurse (APRN) d elivers medical care...management , coordination of services, public speaking, trainings and utilization of community resources. This includes providing support both… more
    University of Miami (10/04/24)
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  • Registered Nurse Surgery Center Per…

    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
    Fresenius Medical Center (09/12/24)
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  • Case Manager Registered Nurse - Full…

    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
    University of Miami (08/30/24)
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  • RN Nurse Manager Med Surg

    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
    HCA Healthcare (09/28/24)
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  • Care Review Clinician, Inpatient Review…

    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
    Molina Healthcare (09/27/24)
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  • *Skillbridge* Special Operations Nurse Case…

    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 (09/25/24)
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  • Special Operations Nurse Case Manager

    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
    KBR (07/26/24)
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  • MDS Nurse F/T

    Palmetto Subacute Care Center (Miami, FL)
    …documentation to the Director of Nursing Qualifications/Requirements: + Must hold a current Registered Nurse License in good standing within the state of ... home for the frail elderly that we serve. MDS Coordinator/ RN Job Description: The MDS Nurse must...the Administrator shall be responsible for: Duties Include: + Management of the overall process and tracking of all… more
    Palmetto Subacute Care Center (10/03/24)
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  • RN Hospital Bill Audit/Appeal Lead

    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 (09/26/24)
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  • Telephonic Nurse Case Manager II

    Elevance Health (Miami, FL)
    …required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care ... **Telephonic Nurse Case Manager II** **Location: This is a...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
    Elevance Health (10/04/24)
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  • Nurse Care Mgr II (US)

    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 (10/01/24)
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  • Director of Quality Management - Inpatient…

    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
    Select Medical (08/27/24)
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  • Core Desk Coordinator - Doral Clinic

    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
    University of Miami (08/09/24)
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