- Humana (Tallahassee, FL)
- …part of our caring community and help us put health first** The Pre-Authorization Nurse 2 reviews prior authorization requests for appropriate care and setting, ... using clinical judgment + Refers to internal stakeholders for review depending on case findings. Educates providers on utilization and medical management… more
- CenterWell (Tallahassee, FL)
- …he / she practices + Have at least 1 year of home health experience. + Prior packet review / QI experience preferred. + Coding certification is preferred. + Must ... from the field staff and assisting with weekly case conferences. Refers clinical questions to Branch Director as necessary. + Maintains the client hospitalization… more
- Evolent Health (Tallahassee, FL)
- …request. + Submitting IT tickets to address barriers to generating cases for clinical review and following the ticket through to completion. + Addressing ... our daily operations this individual also works with our clinical team, which includes our Nurse , ...and policies to determine if submitted requests require a prior authorization review or redirect as required.… more
- Humana (Tallahassee, FL)
- …caring community and help us put health first** The RN, Compliance Nurse 2, Quality Assurance Auditor reviews utilization management activities and documentation to ... and to prevent and detect fraud, waste, and abuse. The RN, Compliance Nurse 2, Quality Assurance Auditor ensures mandatory reporting is completed. Conducts and… more
- Sanofi Group (Tallahassee, FL)
- …with healthcare professionals, primarily the center coordinating genetic counselor, registered nurse , or other ancillary staff. The PEL works collaboratively in a ... settings (eg, home and outpatient), ensuring healthcare professionals are knowledgeable prior to treating patients. Coordination with field team members as… more
- HCA Healthcare (Tallahassee, FL)
- …patient centered care model. In this role you will be required to make clinical assessments of situations and manage treatment autonomously. You would be part of a ... the interdisciplinary team** **Requirements:** **. Licensed as a Registered Nurse in the State of Florida or able to...the State of Florida or able to obtain licensure prior to start is required** **. 1 year of… more
- HCA Healthcare (Tallahassee, FL)
- …of psychiatric illnesses. In this role you will be required to make clinical assessments of situations and manage treatment autonomously. You would be part of ... throughout their stay **Requirements:** . Licensed as a Registered Nurse in the State of Florida or able to...the State of Florida or able to obtain licensure prior to start is required . 1 year of… more
- HCA Healthcare (Tallahassee, FL)
- …patient centered care model. In this role you will be required to make clinical assessments of situations and manage treatment autonomously. You would be part of a ... throughout their stay.** **Requirements:** + **Licensed as a Registered Nurse in the State of Florida or able to...the State of Florida or able to obtain licensure prior to start is required** + **1 year of… more
- HCA Healthcare (Tallahassee, FL)
- …patient centered care model. In this role you will be required to make clinical assessments of situations and manage treatment autonomously. You would be part of a ... throughout their stay. **Requirements:** + Licensed as a Registered Nurse in the State of Florida or able to...the State of Florida or able to obtain licensure prior to start is required + 1 year of… more