- 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
- BayCare Health System (St. Petersburg, FL)
- … Management or 6 years of clinical nursing **Certifications and Licensures:** + Required RN ( Registered Nurse ) + Preferred ACM (Case Management) + Preferred ... trust, dignity, respect, responsibility and clinical excellence. **The Team Lead Utilization Review responsibilities include:** + Directing and coordinating the… more
- Molina Healthcare (St. Petersburg, FL)
- … and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must be active and unrestricted ... **Job Description** **Job Summary** The Medical Review Nurse provides support for medical...our Appeals and Grievances department. We are seeking a Registered Nurse with previous Appeals experience. The… 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
- Veterans Affairs, Veterans Health Administration (Tampa, FL)
- Summary James A Haley is excited to recruit a Registered Nurse , Nursing Officer of the Day (NOD) . This registered nurse would be responsible and ... Administrative Officer (AOD), Transfer Coordinator, the Emergency Room, Admissions, Utilization Review , and Acute Care charge nurses...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Fresenius Medical Center (St. Petersburg, FL)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… 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
- Elevance Health (Tampa, FL)
- …physical and/or behavioral health practitioners responsible for coordinating member service, utilization , access, care management and/or concurrent review to ... reside in the state of Florida* The **Manager of Utilization Management** is responsible for managing a team of...would provide an equivalent background. + Current active unrestricted RN , PA, LSW, LCSW, LPC, LMHC or other accepted… more
- Elevance Health (Tampa, FL)
- …following standard procedures that do not require the training or skill of a registered nurse . **How You Will Make an Impact** Primary duties may include, ... a minimum of 2 years of clinical experience and/or utilization review experience. + Current active, valid...experience. + Current active, valid and unrestricted LPN/LVN or RN license and/or certification to practice as a health… 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
- HCA Healthcare (Trinity, FL)
- …related field required; Master's Degree preferred .Current Florida licensure as a Registered Nurse preferred _**If serving as facility's primary Risk Manager, ... Quality) OR CHCQM (Diplomate in American Board of Quality Assurance and Utilization Review Physicians) _Individuals without CPHQ or ABQUARP will be granted a 12… 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 ... reside in the state of Florida** The **Medical Management Nurse ** will be responsible for review of...an equivalent background. + 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
- 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 ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… 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)
- **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