• Observation Utilization Review RN

    Trinity Health (Fort Lauderdale, FL)
    …years acute hospital clinical experience is required.** Recent experience in case management , utilization review , discharge planning, ongoing monitoring and ... Care Plans to ensure authorization for hospital stay. Hybrid Position **_Position Purpose:_** ** Utilization Review (UR) Nurses play a vital role in healthcare by… more
    Trinity Health (08/02/25)
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  • Utilization Management Nurse

    CenterWell (Tallahassee, FL)
    …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
    CenterWell (08/08/25)
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  • Utilization Management Nurse

    CenterWell (Tallahassee, FL)
    …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Orthopedic procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare… more
    CenterWell (08/02/25)
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  • Non-Clinical Coding and OASIS Review

    BAYADA Home Health Care (Orlando, FL)
    …full time OASIS Review and Coding Manager . The OASIS and Coding Review Manager provides support to all BAYADA Home Health Care Medicare service offices ... and procedures. As a member of the Medicare Case Management (MCM) office, individuals in this role are expected...should be available Monday-Friday from 8:30am-5:00pm. _Medicare, Coder, OASIS Review , Utilization Review , Quality Assurance,… more
    BAYADA Home Health Care (07/01/25)
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  • Hybrid Clinical Review Nurse

    Actalent (Sunrise, FL)
    …activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management + Interqual + Milliman Commercial Guidelines ... Working under the general supervision of the Director and/or Manager /Supervisor of Medical Management , and in collaboration...+ Valid Florida Driver's License. + Knowledge of case management and utilization review concepts,… more
    Actalent (08/09/25)
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  • Acute Care Case Manager , Registered Nurse…

    ChenMed (North Miami Beach, FL)
    …of 2 years' clinical work experience required. + A minimum of 1 year of utilization review and/or case management , home health, hospital discharge planning ... as well as, their home environments. The Nurse Case Manager 1 (RN) role also involves establishing relationships with...patients' progress and adjust and plan accordingly. + Understanding utilization review and how to leverage with… more
    ChenMed (05/28/25)
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  • Manager Case Management

    HCA Healthcare (Gainesville, FL)
    …physical, psycho-social, financial). 1. Participates in IDT rounds, 1. Conducts utilization review , evaluates clinical information, and communicates findings to ... Florida North Florida Hospital team is looking for a(an) Manager Case Management . HCA Healthcare is an...on a timely basis in accordance with the NFRMC Utilization Review Plan and managed care contractual… more
    HCA Healthcare (08/02/25)
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  • RN Quality Review Nurse Home Health

    AdventHealth (Orlando, FL)
    …you'll contribute:** The Population Health Case Manager (PHCM) ensures effective utilization and case management oversight activities as defined by inter ... **Population Health Case Manager (RN) AdventHealth Home Health** **All the benefits...best practices, agency policies/processes. Ensures clear and appropriate visit utilization using evidence-based and best practice guidelines to achieve… more
    AdventHealth (08/07/25)
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  • Manager , Technology Business…

    Ryder System (Tallahassee, FL)
    …here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **JOB SUMMARY:** The Manager of Technology Business Management (TBM) leads ... _Job Seekers can review the Job Applicant Privacy Policy by clicking...continuous improvement of TBM capabilities - including IT Financial Management (ITFM), Vendor Management , and Contract … more
    Ryder System (08/08/25)
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  • Manager , Project Management

    AssistRx (Orlando, FL)
    …to process improvement initiatives, to pharmacy client implementations. We are looking for an Manager of Project Management to assist the Director of Project ... their assigned project managers + Ensures PM utilize scope management practices + Review and/or approve Status...transition to operations + Drive to business outcomes & utilization , not just deadlines + Drives adherence to IT… more
    AssistRx (08/09/25)
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