Top 1020 Of nursing Jobs in Winter Haven Fl

Care Review Clinician (BH Licensed) - Remote in FL
Molina Healthcare, Inc. —Florida
- $26.41 - $51.49 an hour
- Full-time
- Remote
- LMFT
- Licensed Clinical Social Worker
- Mid-level
- Health insurance
Care Review Clinician (RN) - Remote in FL
Molina Healthcare, Inc. —Florida
- $26.41 - $51.49 an hour
- Full-time
- Remote
- RN License
- Mid-level
- Critical & Intensive Care
- Health insurance
Pediatric Registered Nurse
Pediatric Health Choice —Haines City, FL
- Full-time
- Mid-level
- Children
- Pediatrics
- Paid holidays
- Disability insurance
Quick Apply
Registered Nurse (RN)
Winter Haven Health & Rehabilitation Center —Winter Haven, FL
- Full-time
- Background check
- CPR Certification
- Skilled nursing facility
Quick Apply
RN Educator
Home Heart Florida —Lakeland, FL
- $40 an hour
- Weekends as needed
- Spanish
- CPR Certification
- RN License
Quick Apply
Nurse Helper
BayCare —Winter Haven, FL
- Part-time
- Hospital
- High school diploma or GED
- Home Health
- Health insurance
- Dental insurance
Registered Nurse
Griswold Home Care For East Polk County —Auburndale, FL
- From $35 an hour
- Per diem
- Background check
- RN License
- Travel
Quick Apply
9d
Nurse Helper Pool (Third Shift) - Winter Haven Hospital
BayCare —Winter Haven, FL
- Full-time
- Float pool
- Hospital
- High school diploma or GED
13d
Behavioral Health RN
BayCare —Winter Haven, FL
- Full-time
- Background check
- Nursing
- RN License
- Health insurance
- Dental insurance
RN, Nurse Case Management, Risk Management - Lakeland
Publix Super Markets, Inc. —Lakeland, FL
- $5,430 - $8,145 a month
- Full-time
- Nursing
- Mid-level
PRN Register Nurse
AH PC Network —Winter Haven, FL
- $31.53 - $50.40 an hour
- PRN
- CPR Certification
- Nursing
- Vital signs
Nurse Vaccinator RN/LPN
ValetVax Consulting —Lakeland, FL
- $30 - $37 an hour
- Temporary
- RN License
- Medical office experience
- HIPAA
- Flexible schedule
Quick Apply
3d
School Nurse
St Joseph Catholic School —Winter Haven, FL
- Part-time
- Nursing
- RN License
- Computer literacy
Nursing Assistant
CFG HEALTH SYSTEM LLC —Bartow, FL
- Part-time
- CPR Certification
- BLS Certification
- High school diploma or GED
Quick Apply
Hospital Care Coordinator - RN Case Management
BayCare —Winter Haven, FL
- Full-time
- Nursing
- RN License
- Hospital
- Health insurance
- Dental insurance
Staffing Coordinator (Non Nurse) Certified Nursing Assistant required
Life Care Center of Winter Haven —Winter Haven, FL
- Full-time
- Background check
- Customer service
- Computer literacy
Quick Apply
6d
Hospital Liaison (RN/LPN) – Hybrid Schedule
Concierge Home Care —Lakeland, FL
- From $75,000 a year
- Full-time
- Hybrid work
- Background check
- RN License
- Hospital
- Mileage reimbursement
- Health insurance
Quick Apply
Nurse Tech
AdventHealth Heart of Florida —Lake Wales, FL
- $15.31 - $24.49 an hour
- PRN
- CPR Certification
- Nursing
- Hospital
Student Health and Wellness Nurse
Language & Literacy Academy for Learning, Inc —Eloise, FL
- Full-time
- RN License
- LPN
- Entry level
- Disability insurance
- Health insurance
Quick Apply
7d
RN, Advanced Care- PREOP AND DISCH HOLDING-DAYS-Orlando Health Lakeland Highlands Hospital
Orlando Health —Lakeland, FL
- Full-time
- Nursing
- Management
- RN License

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Care Review Clinician (BH Licensed) - Remote in FL

Molina Healthcare, Inc. -
Florida

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Job Details

Full-time
$26.41 - $51.49 an hour

Benefits

Health insurance

Qualifications

Productivity software

Full Job Description

JOB DESCRIPTION Job Summary

Provides support for member clinical service review processes specific to behavioral health. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations, and ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

Assesses services for members - ensuring optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines.
Analyzes clinical service requests from members or providers against evidence based clinical guidelines.
Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures.
Conducts reviews to determine prior authorization / financial responsibility for Molina and its members.
Processes requests within required timelines.
Refers appropriate cases to medical directors and presents cases in a consistent and efficient manner.
Requests additional information from members or providers as needed.
Makes appropriate referrals to other clinical programs.
Collaborates with multidisciplinary teams to promote Molina care model.
Adheres to utilization management (UM) policies and procedures.
May work collaboratively with appropriate departments to provide applied behavior analysis (ABA)/behavioral health therapy (BHT) services to Molina members with autism spectrum disorder (ASD) and other related disorders.
May approve requests for BHT by reviewing behavioral assessments and treatment plans for medical necessity and BHT best practice guidelines. This includes but is not limited to: psychological evaluation requests, comprehensive diagnostic evaluations, functional behavioral assessments, and progress reports.
May perform ongoing monitoring of BHT treatment plans to evaluate effectiveness and treatment efficacy.
May provide peer to peer consultation BHT in-network providers to support treatment planning and maximize member progress.
May work collaboratively with ABA providers to ensure best service practices for members.
May create and develops forms, recommendations and guidelines and training for BHT service delivery.
May collaborate and coordinate with behavioral health medical directors, and senior medical directors to ensure proper management of the BHT benefit.

Required Qualifications

At least 2 years health care experience, including experience in behavioral health and/or hospital acute care, or equivalent combination of relevant education and experience.
Licensed Clinical Social Worker (LCSW), Licensed Master Social Worker (LMSW), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC), Licensed Marriage and Family Therapist (LMFT) or equivalent behavioral health licensure. License must be active and unrestricted in state of practice.
May require behavioral analyst experience, and/or board certification/licensure as a behavioral analyst (BCBA and/or LBA).
Demonstrated knowledge of community resources.
Ability to operate proactively and demonstrate detail-oriented work.
Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
Ability to work independently, with minimal supervision and demonstrate self-motivation.
Responsive in all forms of communication, and ability to remain calm in high-pressure situations.
Ability to develop and maintain professional relationships.
Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
Excellent problem-solving, and critical-thinking skills.
Strong verbal and written communication skills.
Microsoft Office suite/applicable software program(s) proficiency.

Preferred Qualifications

Recent hospital behavioral health experience in an intensive care unit (ICU) or emergency room.

#PJHS3

#LI-AC1

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Apply Now

Refine Your Search

of nursing jobs in winter haven fl

Care Review Clinician (BH Licensed) - Remote in FL

Care Review Clinician (RN) - Remote in FL

Pediatric Registered Nurse

Registered Nurse (RN)

RN Educator

Nurse Helper

Registered Nurse

Nurse Helper Pool (Third Shift) - Winter Haven Hospital

Behavioral Health RN

RN, Nurse Case Management, Risk Management - Lakeland

PRN Register Nurse

Nurse Vaccinator RN/LPN

School Nurse

Nursing Assistant

Hospital Care Coordinator - RN Case Management

Staffing Coordinator (Non Nurse) Certified Nursing Assistant required

Hospital Liaison (RN/LPN) – Hybrid Schedule

Nurse Tech

Student Health and Wellness Nurse

RN, Advanced Care- PREOP AND DISCH HOLDING-DAYS-Orlando Health Lakeland Highlands Hospital

I want to receive the latest job alert for of nursing in winter haven fl

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