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Utilization Review Nurse jobs in Tampa, FL

Concurrent Review Nurse I
Tampa, FL 33646 (Downtown area)
Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case...
Desired Experience: RN, Managed Care
Clinical Reviewer
Tampa, FL 33614
Participates in utilization and quality assessment/improvement activities. Excellent knowledge of Utilization Management and URAC standards....
Desired Experience: Home Care
Licensed Utilization Review I
$20 - $24 an hour
2 years of clinical or utilization review experience; Registered Nurse (RN) (Preferred). Review of claim edits, pre-noted inpatient admissions or, episodic...
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Utilization Review Registered Nurse - Psychiatric Unit
Utilization Review Registered Nurse - Psychiatric Unit(Job Number:. The Utilization Review Nurse (RN) will be responsible for ensuring all admissions and...
Desired Experience: RN, BLS Certification
Case Manager Registered Nurse
The RN Case Manager provides hospital case management/utilization review and discharge planning to assure that the patient progresses through the continuum of...
Desired Experience: Case Management, RN

Licensed Utilization Review II (Call Center Nurse)- Tampa FL...

Tampa, FL
Licensed Utilization Review II (Call Center Nurse)- October 8th start date. 2 years of clinical or utilization review experience....
Desired Experience: LPN, RN, Managed Care

Clinical Review Nurse- Utilization Management

Tampa, FL
Follows Utilization Management and URAC standards. Using clinical expertise, reviews utilization information concerning patient care and matches those needs to...

Utilization Management Representative I - Tampa, FL - PS1044...

Tampa, FL
Refers cases requiring clinical review to a Nurse reviewer. Previous Utilization Management experience preferred....

Utilization Management Nurse (RN), Workers' Compensation

Tampa, FL
$65,300 - $81,600 a year
Initiate referrals to Peer Review Services appropriately, and coordinate the services to support the utilization review....
Desired Experience: RN

Pre-Certification Review Nurse

Tampa, FL 33609 (Swann Estates area)
Pre-Certification Review Nurse. The Pre-Certification Reviewer is responsible for the pre-certification of Plan determined procedures utilizing approved...
Desired Experience: LPN, RN, Microsoft Office, Managed Care

UM Compliance Nurse - Medicaid - Tampa Florida Office

Tampa, FL
$68,000 - $74,000 a year
At least 1 year of auditing and chart review experience in one or more of the following areas, prior authorization, care management, utilization management,...
Desired Experience: Time Management, RN, ICD-10, CPT Coding, Microsoft Word, Auditing, Medical Terminology, Managed Care
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Concurrent Review Nurse I

Tampa, FL
Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case...
Desired Experience: RN, Managed Care

Prior Authorization Nurse

Tampa, FL 33634
Preferred 1 year of experience in Performing utilization reviews. Required Licensed Practical Nurse (LPN)....
Desired Experience: Microsoft Word, Time Management, LPN, Excel, Managed Care

UTILIZATION REVIEW SPECIALIST, SENIOR

New Port Richey, FL 34655 +5 locations
The Senior Utilization Review Specialist is responsible for the oversight of the utilization Review Specialists....

Concurrent Review Nurse

Tampa, FL 33609 (Swann Estates area)
Concurrent Review Nurse. The Concurrent Review Nurse is responsible for the management of inpatient and observation services provided to members with a focus on...
Desired Experience: LPN, RN, Microsoft Office, Managed Care
RN Case Manager - Polk County, FL ( Local Travel & Local Tel...
Tampa, FL 33646 (Downtown area)
Registered Nurse with current licensure to practice in the applicable state. Knowledge of utilization management, quality improvement, discharge planning, and...
Desired Experience: Bilingual, Case Manager Certification, Case Management, RN, Microsoft Powerpoint, Microsoft Office
Utilization Management Nurse (RN), Workers' Compensation
$65,300 - $81,600 a year
Initiate referrals to Peer Review Services appropriately, and coordinate the services to support the utilization review....
Desired Experience: RN
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