- Centene Corporation (Tallahassee, FL)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... to ensure appropriate care for members and supervises day-to-day activities of BH utilization management team. + Monitors behavioral health (BH) utilization … more
- CVS Health (Tallahassee, FL)
- …reside in Florida + Licensed Independent Behavioral Health clinician or an unrestricted Registered Nurse ( RN ) license in Florida with psychiatric specialty ... convenient and affordable. **Position Summary** This is a full-time remote Utilization Management Clinical Consultant opportunity for candidates residing in… 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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...the State of Florida + Bachelor's degree + Licensed Registered Nurse ( RN ) in the… more
- Humana (Tallahassee, FL)
- …and help us put health first** Humana Healthy Horizons in Florida is seeking a Utilization Management Nurse who utilizes clinical nursing skills to support ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 's work assignments...Active Licensed Practical Nurse , (LPN) or Licensed Registered Nurse ( RN ) in the… more
- CVS Health (Tallahassee, FL)
- …skills, both verbal and written **Required Qualifications** - 3+ years of experience as a Registered Nurse - Must have active current and unrestricted RN ... 1+ years of clinical experience in acute or post acute setting - Utilization Management is a 24/7 operation and the work schedule may include weekends, holidays,… more
- Humana (Tallahassee, FL)
- …an internship that supports the goal to put health first? The Prior Authorization, Registered Nurse , RN , Intern will review prior authorization requests for ... onsite, field, or remote based opportunities. The Prior Authorization, Registered Nurse , RN , Intern will...experience a plus. + Previous experience in prior authorization, utilization management + Experience working with MCG… more
- Highmark Health (Tallahassee, FL)
- …Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of health care ... depending on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field **SKILLS** + Working knowledge of… more
- Humana (Tallahassee, FL)
- …part of our caring community and help us put health first** The Compliance Nurse Auditor reviews utilization management activities and documentation to ... to prevent and detect fraud, waste, and abuse. The RN Compliance Nurse 2, Quality Assurance Audit...care, skilled and/or rehabilitation clinical setting + Experience with utilization management , pre-service denials and/or quality assurance… more
- Centene Corporation (Tallahassee, FL)
- …and Family Therapist (LMFT) required or Licensed Mental Health Professional (LMHP) required or RN - Registered Nurse - State Licensure and/or Compact State ... abuse across the continuum of care. Experience with managed care, case management , utilization management , or quality improvement. **License/Certification:**… more
- Humana (Tallahassee, FL)
- …your skills to make an impact** **Required Qualifications** + Associate degree + Active Registered Nurse , ( RN ), License in your state of residence without ... management and/or process improvement experience + Minimum 3 years utilization management experience with exposure to grievance and appeals + Proficient in… more
- Centene Corporation (Tallahassee, FL)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
- Guardian Life (Tallahassee, FL)
- …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...plan and length of disability. Plan for ongoing case management through proactive partnering with treating providers to move… more
- HCA Healthcare (Tallahassee, FL)
- …options and costs to patient and patient families. **What qualifications you will need:** + Registered Nurse , or Advance Practice Registered Nurse (APRN) ... **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… more
- YesCare Corp (Tallahassee, FL)
- **Experience & Requirements** + Active license + Registered Nurse required + Minimum of three (3) years of management experience in a healthcare setting. + ... is a list of your responsibilities as a **Health Services Administrator (HSA) RN required** at YesCare: + Manages the healthcare delivery system and coordinates with… more
- CenterWell (Tallahassee, FL)
- …for managing populations and coordinating care to reduce acute and post-acute care utilization . The Clinical Strategy and Practice Lead role is hybrid with a ... key operational metrics, including CIT program impact on patient care utilization and operational efficiency. Provide regular updates to the Director, highlighting… 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)
- …Center have the opportunity to make a real impact. As an Operating Room Nurse - Surgery Center you can be a part of change. **Benefits** Tallahassee Outpatient ... location._** It is an exciting time to be a nurse at HCA Healthcare! Come unlock your career potential...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… more