• Behavioral Health Utilization Review

    Actalent (Sunrise, FL)
    …Furthermore, the UMN provides education on issues related to utilization review and ensures smooth transitions of care , maintaining high provider and ... Job Title: Behavioral Health Utilization Review NurseJob Description The ...policy guidelines. + Promote safe and appropriate coordination of care and optimal utilization of resources. +… more
    Actalent (10/10/25)
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  • Behavioral Health Utilization Review

    Actalent (Fort Lauderdale, FL)
    Actalent is Hiring a Behavioral Health Utilization Review Nurse Job Description We are seeking a dedicated Utilization Management Nurse (UMN) who will work ... process development, and provide education to the team on utilization review -related issues. Responsibilities + Review...policy guidelines. + Promote safe and appropriate coordination of care and optimal utilization of resources. +… more
    Actalent (10/15/25)
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  • Utilization Review RN

    BayCare Health System (Tampa, FL)
    …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN responsibilities include:** + Functions ... all other related parties to ensure appropriate level of care through comprehensive concurrent review for medical...Nursing or Business **Experience:** + Required 2 years in Utilization Review or + Required 2 years… more
    BayCare Health System (10/10/25)
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  • Associate Manager , Clinical Health…

    CVS Health (Tallahassee, FL)
    …that promote high-quality healthcare for members. **Position Summary** The Associate Manager is responsible for oversight of Utilization Management staff. ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
    CVS Health (10/15/25)
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  • Pharmacist, Utilization Management (UM)…

    Molina Healthcare (Tampa, FL)
    …(such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services ... (such as, therapeutic drug monitoring, drug regimen review , patient education, and medical staff interaction), and oversight (establishing and measuring performance… more
    Molina Healthcare (10/16/25)
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  • Care Manager LPN

    Community Health Systems (Naples, FL)
    …** Comprehensive benefits (Medical, Dental, Vision) **Job Summary** The Care Manager - LPN supports effective utilization management and discharge planning ... care planning. + Ensures accurate and timely documentation of utilization review , discharge planning activities, and patient interactions in accordance… more
    Community Health Systems (10/16/25)
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  • Registered Nurse Care Manager

    AdventHealth (Winter Park, FL)
    …at the AdventHealth Orthopedic Institute **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses, ... care coordination and progression through the continuum of care . The RN Care Manager ...needed. + Actively participates in daily Multidisciplinary Rounds to review progression of care and discharge plan… more
    AdventHealth (10/14/25)
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  • Manager Care Management

    Cleveland Clinic (Port Saint Lucie, FL)
    …A caregiver in this role utilizes clinical expertise and understanding of utilization review requirements, discharge planning process, and Medicare regulations ... where you belong, here at Tradition Hospital. As a Manager of Care Management, you will supervise...in the development of department practices and procedures for utilization review and discharge planning, ensuring compliance… more
    Cleveland Clinic (09/03/25)
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  • Registered Nurse Care Manager PRN

    AdventHealth (Winter Garden, FL)
    …GROVE BOULEVARD, Winter Garden, 34787** **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses, ... care coordination and progression through the continuum of care . The RN Care Manager ...BSN or Health-related Master's degree or MSN + Prior Care Management/ Utilization Management experience This facility is… more
    AdventHealth (10/15/25)
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  • Registered Nurse Care Manager Part…

    AdventHealth (Daytona Beach, FL)
    …MEMORIAL MEDICAL PKWY, Daytona Beach, 32117 **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses, ... care coordination and progression through the continuum of care . The RN Care Manager ...BSN + Health-related Master's degree or MSN + Prior Care Management/ Utilization Management experience ACM/CCM Certification This… more
    AdventHealth (10/03/25)
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