• Nurse Reviewer I

    Elevance Health (FL)
    …in an ambulatory or hospital setting or minimum of 1 year of prior utilization management , medical management and/or quality management , and/or ... ** Nurse Reviewer I** **Location:** This role enables associates...required. **Preferred Experience, Skills, and Capabilities:** + Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding,… more
    Elevance Health (09/26/25)
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  • Appeals Nurse Reviewer I

    Elevance Health (FL)
    …in an ambulatory or hospital setting or minimum of 1 year of prior utilization management , medical management and/or quality management , and/or ... **Appeals Nurse Reviewer I** **Location:** This role enables associates...required. **Preferred Experience, Skills, and Capabilities:** + Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding,… more
    Elevance Health (09/26/25)
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  • Social Work Specialist

    AdventHealth (New Smyrna Beach, FL)
    …The Social Work Specialist is under the general supervision of the Care Management Supervisor or Manager and is responsible for patient evaluations of ... for individuals from at-risk populations from interdisciplinary team members (including physicians, RN Care Managers, staff nurses, and other members of the care… more
    AdventHealth (08/27/25)
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  • Clinical UM Nurse 2

    CenterWell (Tallahassee, FL)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... skills to make an impact** **Required Qualifications** + Licensed Registered Compact Nurse license ( RN )...volume and fast paced environment + Previous experience in utilization management + Education: BSN or Bachelor's… more
    CenterWell (09/26/25)
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  • Clinical Social Worker Licensed

    AdventHealth (Apopka, FL)
    …The Clinical Social Worker, Licensed, is under the general supervision of the Care Management Supervisor or Manager and is responsible for patient evaluations of ... for individuals from at-risk populations from interdisciplinary team members (including physicians, RN Care Managers, staff nurses, and other members of the care… more
    AdventHealth (10/02/25)
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  • Licensed Clinical Social Worker East Orlando…

    AdventHealth (Orlando, FL)
    …The Clinical Social Worker, Licensed, is under the general supervision of the Care Management Supervisor or Manager and is responsible for patient evaluations of ... for individuals from at-risk populations from interdisciplinary team members (including physicians, RN Care Managers, staff nurses, and other members of the care… more
    AdventHealth (09/25/25)
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  • Licensed Clinical Social Worker PRN

    AdventHealth (Celebration, FL)
    …The Clinical Social Worker, Licensed, is under the general supervision of the Care Management Supervisor or Manager and is responsible for patient evaluations of ... for individuals from at-risk populations from interdisciplinary team members (including physicians, RN Care Managers, staff nurses, and other members of the care… more
    AdventHealth (09/10/25)
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  • Licensed Clinical Social Worker Part Time

    AdventHealth (Orange City, FL)
    …The Clinical Social Worker, Licensed, is under the general supervision of the Care Management Supervisor or Manager and is responsible for patient evaluations of ... for individuals from at-risk populations from interdisciplinary team members (including physicians, RN Care Managers, staff nurses, and other members of the care… more
    AdventHealth (08/07/25)
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  • Social Work Specialist

    AdventHealth (Orlando, FL)
    …The Social Work Specialist is under the general supervision of the Care Management Supervisor or Manager and is responsible for patient evaluations of ... for individuals from at-risk populations from interdisciplinary team members (including physicians, RN Care Managers, staff nurses, and other members of the care… more
    AdventHealth (09/10/25)
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  • Director GBD Special Programs Services

    Elevance Health (Miami, FL)
    …related field, including prior management experience and clinical, quality, and/or utilization management experience in a managed care setting; or any ... Direct and oversees program operations in support of corporate and health plan management in execution of clinical service delivery. + Monitors national and local… more
    Elevance Health (09/26/25)
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