Utilization Review Specialist Senior
BayCare Medical Group
At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward‑thinking philosophy that’s built on a foundation of trust, dignity, respect, responsibility and clinical excellence. The Utilization Review Specialist Senior responsibilities include: Functions as the primary liaison between the funding agents and all other related parties to ensure appropriate level of care through comprehensive concurrent review for medical necessity of outpatient observation and inpatient stays and the utilization of ancillary services. Perform other duties as assigned by the supervisor including but not limited to processing concurrent denials. Preferred experience includes Critical Care or Emergency Nursing RN. Position details: Location: Hybrid - St Josephs Hospital/Tampa, FL Status: PRN, As Needed Schedule: Days vary Weekend Requirement: Strongly prefer availability for every other weekend On Call: No Certifications and Licensures: Required RN (Registered Nurse) Preferred ACM (Case Management) Preferred CCM (Case Manager) Education: Required Associates in Nursing or Required Bachelors in Nursing Preferred Masters in Nursing or Business Experience: Required 2 years in Utilization Review or Required 2 years in Case Management or Required 3 years Registered Nurse Preferred experience in Critical Care or Emergency Service Benefits: Tuition reimbursement 401k match and additional yearly contribution Community discounts and more Equal Opportunity Employer Veterans/Disabled Position Utilization Review Specialist Senior Location Tampa:St Josephs | Clinical | PRN Req ID 143041 #J-18808-Ljbffr
- ...A large healthcare provider in Tampa is seeking a Utilization Review Specialist Senior. This hybrid position involves acting as a liaison for funding agents and ensuring appropriate levels of care through comprehensive reviews. Candidates must have a Registered Nurse...SeniorWeekend work
$144.5k - $175.1k
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Overview Senior Specialist, Benefit Operations — plays a central role in managing and coordinating... ...benefit programs. Responsibilities Utilize ServiceNow ticket system to research and... ...present data for second-level appeals. Review and update employee reference materials...SeniorFull timeSummer workLive inWork at officeLocal areaRemote work$68.43k - $82.92k
## Senior Specialist, Benefit OperationsTampa - FL - USFind out how well you match with this job... ...community they support.**Essential Functions:**Utilize ServiceNow ticket system to research... ...relevant data for second-level appeals.Review and update employee reference materials...SeniorHourly payFull timeTemporary workPart timeFor contractorsSummer workLive inWork at officeLocal areaRemote workFlexible hoursShift work- ...individuals with disabilities. California residents click here to review your privacy rights. It is unlawful in Massachusetts to... ..., possibly including Workday, Loop, and HireVue. These systems utilize text messages to communicate with you throughout the...Full timePart timeLocal areaImmediate startMonday to FridayWeekend work
- ...experience in healthcare, and recent experience in case management or oncology nursing. Responsibilities include discharge planning and utilization review for inpatients, emphasizing leadership and effective resource management in a clinical setting. #J-18808-Ljbffr...Senior
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$90k - $100k
Sr. AR Specialist Focus Search LLC is recruiting for a Sr. AR Specialist for a rapidly growing... ...generation, batching, and month‑end review, support and enhance automation across billing... ..., and process‑improvement mindset Seniority level Mid‑Senior level Employment type...SeniorFull timeFlexible hours- ...The Intelligence Management Specialist (Operations) - Sr. provides comprehensive... ..., reports, and briefings; reviewing and formatting documents;... ...and associated emitters utilizing ELINT data sources, tools, and... ...additional 5 years of related senior experience, for a total of 17...Senior
$15 per hour
...for you!Compensation Rate: $15.00/hrWhat you get to do:As a Senior Safety Specialist, you willAssist with developing, maintaining, and... ...compliance, audit vehicles and equipment for inspections, review training records, and chemical inventories and proper storage...SeniorLocal areaFlexible hoursShift workNight shiftWeekend work$66.39k - $80.44k
Global Purchasing Senior Specialist The Global Purchasing Senior Specialist plays a crucial role in coordinating and leading financial and... ...regarding procurement and finance policies and procedures, utilizing SAP, ARIBA, and Icertis. Work with HR and Finance to manage...SeniorFull timeContract workRemote work- ...Senior Therapeutic Area Specialist - Oncology/Hematology- Tampa, FL Working with Us Challenging. Meaningful. Life-changing. Those aren't words... ...of healthcare business and interacting with HCPs. ~ Utilizing various digital communication channels such as emails, instant...SeniorPrivate practiceWork at office
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Senior Proposal Specialist (Federal Market) CDM Smith is expanding the marketing team within our Federal Services Unit and is seeking a proven Senior... ..., competitors, and potential teaming partners; review and analyze FedBizOpps synopses, requests for proposals, and...SeniorContract workWork at officeRemote workOverseas- Senior HUMINT Targeting Specialist - (2190) Job Title Senior HUMINT Targeting Specialist Location Tampa, FL 33621 US (Primary) Category Job Type... ...and analyze Publicly Available Information (PAI) utilizing managed attribution research tools in support of CI/HUMINT...SeniorFull timeContract work
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- ...currently seeking a Sr Geospatial Analyst / LiDAR Calibration Specialist in our Tampa, FL or Fairfax, VA offices. Remote positions... ...processed data to ensure it meets rigorous accuracy requirements Review and validate post-processed LiDAR data sets for completeness...SeniorLocal areaRemote work
- Senior MRO Sourcing Specialist As a Senior Sourcing Specialist - MRO at Mosaic, you’ll play an important role in supporting MRO procurement with a... ...strategic sourcing process, including category analysis, data review, and reporting. Develop fact‑based category strategies...SeniorContract workFor contractorsWork at office
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...consider a career in Advisory. KPMG is currently seeking a Senior Specialist, MAST Application Penetration Tester to join our Managed... ...application business logic, and perform application architecture reviews Demonstrate application testing experience in real time via...SeniorH1bLocal area- ...Commercial, and Energy; and Transportation. We are looking for a Senior Proposal Specialist to join our Marketing Team. Typical responsibilities... ...North Carolina. Facilitate pursuit teams through color reviews, develop qualifications, edit technical approaches, and...SeniorTemporary workWork at officeWork from homeFlexible hours3 days per week
$15 per hour
...safety regulations. Conduct inspections of work areas and ambassadors for compliance, audit vehicles and equipment for inspections, review training records, and chemical inventories and proper storage. Complete daily, weekly and monthly regulatory inspections of the...SeniorLocal areaFlexible hoursShift workNight shiftWeekend work$95.86k - $208.27k
...consider a career in Advisory. KPMG is currently seeking a Senior Specialist, SOC Analyst Level II to join our Advisory Services practice.... ..., deep dive intrusion analysis, event correlation, forensic review, and determining when events meet incident thresholds to engage...SeniorH1bLocal areaShift workNight shiftWeekend work$62.9k - $66.81k
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- ...File Compliance Specialist, Real Estate - Remote Responsibilities Work closely with our team to ensure a complete online broker file... ...CAR forms and be able to ascertain their completeness. Review a high volume of documents continuously without shifting focus...Work at officeRemote workShift work
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- ...all Federal, State, and local laws related to the employment of qualified individuals with disabilities. California residents may review their privacy rights. It is unlawful in Massachusetts to require or administer a lie‑detector test as a condition of employment or...Full timeLocal areaMonday to FridayWeekend work
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