• Utilization Review Nurse

    Actalent (Sunrise, FL)
    Utilization Management Nurse !Job Description The ...on department activities as assigned. Essential Skills + Clinical review + Utilization review + ... utilization . Working under the general supervision of the Director and/or Manager/Supervisor of Medical Management, and in collaboration...or LPN License. + Minimum of one year of utilization review experience and discharge planning in… more
    Actalent (08/21/25)
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  • Utilization Management Nurse

    CVS Health (Tallahassee, FL)
    …(RN) - active license. + 3+ Years of clinical experience. + 1+ Year of Utilization Review Management and/or Medical Management experience. + Must have active and ... a collaborative process to implement, coordinate, monitor and evaluate medical review cases. + Applies the appropriate clinical criteria/guideline and plan language… more
    CVS Health (08/15/25)
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  • Utilization Management Nurse

    Actalent (Sunrise, FL)
    …UMN assists in complex cases, develops internal processes, and educates physicians on utilization review issues. The role involves managing continuity of care, ... Actalent is hiring a Utilization Management Nurse ! Job Description The...on department activities as assigned. Essential Skills + Clinical review + Utilization review +… more
    Actalent (08/21/25)
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  • Acute Care Manager, Complex Care (Registered…

    ChenMed (Pembroke Pines, FL)
    …engagement with patient and family. + Facilitate patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... we need great people to join our team. The Nurse Case Manager I position is responsible for achieving...achieving desired clinical outcomes within specific timeframe. + Conducts review for appropriate utilization of services from… more
    ChenMed (08/16/25)
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  • Medical Director (Marketplace)

    Molina Healthcare (St. Petersburg, FL)
    …the Chief Medical Officer. + Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the ... and interacts with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource… more
    Molina Healthcare (08/28/25)
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  • Director Case Management

    HCA Healthcare (Kissimmee, FL)
    …and external agencies to ensure continuity of care and optimal clinical resource utilization . The Director has oversight for all aspects of daily hospital ... through actively engaging interdisciplinary teams and external stakeholders. The Director is a registered nurse with responsibility...personal growth, we encourage you to apply for our Director Case Management opening. We promptly review more
    HCA Healthcare (06/21/25)
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  • Director of Case Management ( RN / RT / MSW…

    Select Medical (Gainesville, FL)
    …and professional growth of the department, including, but not limited to: Utilization Review (UR) and resource management, discharge planning, treatment plan ... **Overview** **Critical Illness Recovery Hospital** ** Director of Case Management** **$10,000 Sign On Bonus**...**$10,000 Sign On Bonus** **_Clinical license as a registered nurse or respiratory therapist or master's in social work… more
    Select Medical (08/02/25)
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  • Behavioral Health Nurse - Managed Care

    DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
    …+ Participate in interdisciplinary case rounds, quality improvement initiatives, and utilization review processes. + Support members during transitions of ... Position is On-Site The Behavioral Health Nurse - Managed Care is responsible for coordinating,...+ Experience in a managed care, case management, or utilization review setting + Strong understanding of… more
    DOCTORS HEALTHCARE PLANS, INC. (08/24/25)
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  • Senior Registered Nurse Supv

    MyFlorida (Port Charlotte, FL)
    SENIOR REGISTERED NURSE SUPV - 50009026 Date: Aug 25, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... No: 859588 Agency: Veterans Affairs Working Title: SENIOR REGISTERED NURSE SUPV - 50009026 Pay Plan: Career Service Position...Works under the direct supervision of the Executive Nursing Director (DON). Supervise and direct nursing personnel on an… more
    MyFlorida (08/26/25)
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  • Site Medical Director

    YesCare Corp (Tallahassee, FL)
    …measures including sentinel event review + Actively participant of the Utilization Review process and follow proper procedures. + Follows standard ... or nurse practitioners as required. + Notifies Regional Medical Director and Site Health Services Administrator of schedule changes. Assists in arrangement… more
    YesCare Corp (08/22/25)
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