- Wellpath (Fort Lauderdale, FL)
- …for training, education, and point of care support. **How you make a difference** The Utilization Management Registered Nurse works under the guidance of ... more
- MyFlorida (Pembroke Pines, FL)
- SENIOR REGISTERED NURSE SUPV - 50000209 1 Date: Feb 12, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... more
- ChenMed (Miami, FL)
- …We're rapidly expanding and we need great people to join our team. The Registered Nurse , CareLine, PRN is responsible for providing telephonic triage directional ... more
- University of Miami (Miami, FL)
- …this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Advanced Practice Registered Nurse Pediatrics, Child Protection ... more
- ChenMed (Miami, FL)
- …We're rapidly expanding and we need great people to join our team. The Registered Nurse , Virtual Care is responsible for providing telephonic triage directional ... more
- University of Miami (Miami, FL)
- …of Case Management . + Incorporates the fundamental principles of utilization management , monitoring resource consumption, social services intervention and ... more
- Fresenius Medical Center (Fort Lauderdale, FL)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... more
- Molina Healthcare (Miami, FL)
- …driver's license **PREFERRED EDUCATION:** **PREFERRED EXPERIENCE:** + 3-5-year experience as a Registered Nurse and/or Nurse Practitioner, ideally in a ... more
- Molina Healthcare (Miami, FL)
- …Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + ... more
- HCA Healthcare (Tamarac, FL)
- …of care. **What qualifications you will need:** + Current Florida license as Registered Nurse or Recognized Compact Licensure (subject to Florida State Licensing ... more
- HCA Healthcare (Margate, FL)
- …of care. **What qualifications you will need:** + Current Florida license as Registered Nurse or Recognized Compact Licensure (subject to Florida State Licensing ... more
- Molina Healthcare (Miami, FL)
- …of payment decisions. + Serves as a clinical resource for Utilization Management , Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. ... more
- Surgery Care Affiliates (Fort Lauderdale, FL)
- …and differentiated ways as part of Optum and with our new Specialty Management Solutions business. + We have pioneered a physician-led, multi-site model of practice ... more
- University of Miami (Miami, FL)
- …Care Coordination provides strategic leadership and oversight of care coordination, case management , social services, and utilization management across all ... more
- Molina Healthcare (Miami, FL)
- …site of service. **This position is seeking someone with experience in utilization management . Please include your experience on your resume.** ... more
- Molina Healthcare (Miami, FL)
- …integrated) performing one or more of the following activities: utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.). ... more
- Select Medical (Miami, FL)
- …of acute transfers and other CQI indicators. **Qualifications** **Minimum Qualifications** + Registered Nurse with valid state license. Legacy employees may ... more
- Molina Healthcare (Miami, FL)
- …materials and other related documentations. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational ... more
- Centers Plan for Healthy Living (Margate, FL)
- …Healthy Living is currently accepting applications for Full Time Registered Nurse without experience. The Utilization Management Clinical Reviewer works ... more
- Molina Healthcare (Miami, FL)
- …State Registered Nursing (RN) license in good standing. + Utilization Management Certification (CPHM) Certified Professional in Health Care Quality ... more