We interpreted Midway, FL as Midway, FL. Other options include: Midway (Seminole County), FL
- CVS Health (Tallahassee, FL)
- …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in ET zones **Education**… more
- CVS Health (Tallahassee, FL)
- …1+ years of clinical experience in acute or post-acute setting, and 1+ years of Utilization Management / Care Management Experience + Must have active ... additional Nursing Licenses as business needs require. **Preferred Qualifications** Utilization Management experience preferred **Education** Education: Diploma… more
- CVS Health (Tallahassee, FL)
- …years of clinical experience in acute or post-acute setting,and 1+ years of Utilization Management / CareManagementExperience + Must have active current and ... obtainadditionalNursing Licenses as business needsrequire. * **Preferred Qualifications** - Utilization Management experience preferred - **Anticipated Weekly… more
- CenterWell (Tallahassee, FL)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- 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
- Centene Corporation (Tallahassee, FL)
- …28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive ... Analyzes BH member data to improve quality and appropriate utilization of services + Interacts with BH healthcare providers...Certified Behavior Analyst (BCBA) required + RN - Registered Nurse - State Licensure and/or Compact State Licensure RN… more
- MyFlorida (Chattahoochee, FL)
- REGISTERED NURSE SPECIALIST - F/C - 67072411 APD/ DDDP CHATTAHOOCHEE, FL Date: Dec 9, 2025 The State Personnel System is an E-Verify employer. For more information ... Agency: Agency for Persons with Disabilities Working Title: REGISTERED NURSE SPECIALIST - F/C - 67072411 APD/ DDDP CHATTAHOOCHEE,...dynamics. This position with APD will serve staff and management across the Agency. Your work will impact the… more
- Centene Corporation (Tallahassee, FL)
- …findings, discharge plans, and actions taken on member medical records in health management systems according to utilization management policies and ... preferred. Knowledge of Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. **License/Certification:** + LPN -… more
- Evolent (Tallahassee, FL)
- …Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed ... medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care across the continuum… more
- HCA Healthcare (Tallahassee, FL)
- …**Introduction** Do you have the PRN career opportunities as an Operating Room Nurse PRN-Surgery Center you want with your current employer? We have an exciting ... Do you want to work as an Operating Room Nurse PRN-Surgery Center where your passion for creating positive...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… more
- HCA Healthcare (Tallahassee, FL)
- …passionate about delivering patient-centered care?** Submit your application for Operating Room Nurse - Surgery Center position and spend more time at the bedside ... to deliver clinical excellence behind the scenes in data science, case management or transfer centers. Unlock your potential at Tallahassee Outpatient Surgery… more
- Intermountain Health (Tallahassee, FL)
- …cost-effective outcomes. Provides focused support to various areas such as utilization management , emergency department, acute, ambulatory and specialty care. ... in examining patterns of health care needs, decisions, lifestyle choices, and utilization of resources that affect their health. + Advocates, educates and coaches… more
- Humana (Tallahassee, FL)
- …Office products including Word, Excel and Outlook **Preferred Qualifications** + Utilization Review/Quality Management experience + Experience working with MCG ... community and help us put health first** The Appeals Nurse 2 resolves clinical complaints and appeals. The Appeals... 2 resolves clinical complaints and appeals. The Appeals Nurse 2 work assignments are varied and frequently require… 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 ... of Florida with an acceptable driving record required, unless waived by management . Management & Training Corporation (MTC) is an Equal Opportunity Employer. All… more
- HCA Healthcare (Tallahassee, FL)
- **Description** **Introduction** Do you have the career opportunities as a(an) Manager Case Management you want in your current role? We invest in what matters most ... meet these needs. + Develops, initiates, and coordinates individual patient case management plans to ensure appropriate level of care across the continuum. Ensures… more
- HCA Healthcare (Tallahassee, FL)
- …to Patient in Bed by facility by floor to identify opportunities + Assesses utilization of Bed Management technology for optimal use + Performs staffing ... that invests in you as a(an) Director PI Bed Management ? At HCA Healthcare, you come first. HCA Healthcare...for the implementation of process improvement ideas. + Educates nurse supervisors, unit secretaries, unit directors, and other staff… more
- HCA Healthcare (Tallahassee, FL)
- …and assess observation patients for appropriateness in observation status + Performs utilization management reviews and communicates information to third party ... location._** It is an exciting time to be a nurse at HCA Healthcare! Come unlock your career potential...position if current and compliant** + **Certification in Case Management , Nursing, or Utilization Review, preferred** +… more
- HCA Healthcare (Tallahassee, FL)
- …and assess observation patients for appropriateness in observation status + Performs utilization management reviews and communicates information to third party ... required within90 days of hire** + **Advanced Practice Registered Nurse license is acceptable for position if current and...position if current and compliant** + **Certification in Case Management , Nursing, or Utilization Review, preferred** +… more
- HCA Healthcare (Tallahassee, FL)
- …and assess observation patients for appropriateness in observation status + Performs utilization management reviews and communicates information to third party ... within 90 days of hire + Advanced Practice Registered Nurse license is acceptable for position if current and...position if current and compliant + Certification in Case Management , Nursing, or Utilization Review, preferred +… more
- Highmark Health (Tallahassee, FL)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC). + Delaware RN license must...is part of the compact **Preferred** + Certification in Utilization Management or a related field **SKILLS**… more