• Utilization Management Nurse

    Actalent (Sunrise, FL)
    …satisfaction, safety, and appropriate length of stay. Responsibilities + Review prior authorization requests for medical necessity and appropriateness using ... Actalent is hiring a Utilization Management Nurse ! Job Description The Utilization Management Nurse...with the interdisciplinary team to perform reviews of service authorization requests, ensuring the utilization of appropriate services. The… more
    Actalent (08/21/25)
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  • Care Review Clinician, Inpatient Review…

    Molina Healthcare (FL)
    …financial responsibility for Molina Healthcare and its members. May also perform prior authorization reviews and/or related duties as needed. + Processes ... acute care/medical experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. Must… more
    Molina Healthcare (08/03/25)
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  • RN BH Intake Specialist

    HCA Healthcare (Tampa, FL)
    …to qualify patients for current or continued care needs, obtaining pre-admission authorization prior to admission.** **Requirements:** + **Must be licensed as ... **Introduction** Do you have the career opportunities as a RN Psych Intake Specialist you want in your current...a RN , LCSW, LMHC or LMFT in accordance with state… more
    HCA Healthcare (07/14/25)
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  • (USA) Staff Nurse , Specialty Pharmacy…

    Walmart (Orlando, FL)
    …qualifications for this position. If none are listed, there are no minimum qualifications._ Registered Nurse ( RN ) Licensure in state of practice 1 year's ... adherence by addressing barriers and coordinating with prescribers, pharmacists, and prior authorization teams. + Monitor patient health status, assess… more
    Walmart (08/16/25)
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  • Utilization Review Clinician - Behavioral Health

    Centene Corporation (Tallahassee, FL)
    …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... of care and services are medically appropriate + Performs prior authorization reviews related to mental health...Care only: LMSW, LCSW, LMHC, LPC, LMFT, LMHP or RN required Pay Range: $26.50 - $47.59 per hour… more
    Centene Corporation (08/10/25)
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  • Asst Resident Services Director

    Allegro Management Company Llc (Parkland, FL)
    …use of purchase order system and budget control procedures (including appropriate prior authorization on capital expenditure purchases). + Supervise the Care ... Where Clinical Excellence Meets Elegant Living Are you a nurse leader with a heart for seniors and a...Bring: + A valid FL Nursing License (LPN or RN ) + Strong clinical skills & a love for… more
    Allegro Management Company Llc (06/27/25)
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  • Associate Director, Provider Engagement - Oncology…

    Evolent (Tallahassee, FL)
    …Managers to ensure successful adoption and engagement of Evolent's solutions (ie, prior authorization , clinical pathways) to ensure timely patient access to ... and/or practice transformation + Highly preferred oncology clinical experience (ie, RN , NP) + Must demonstrate knowledge of healthcare delivery operations,… more
    Evolent (07/25/25)
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  • Mission Control RN Tier1 Transfer Center FT…

    AdventHealth (Orlando, FL)
    …role you'll contribute:** The Mission Control RN Tier 1 is a professional registered nurse functioning withing Mission Control in one of three primary roles. ... and/or nursing units for AdventHealth. . The Mission Control RN is a highly trained professional with independent decision-making...State of Florida or multi state license as a Registered Nurse . Graduate of school of Nursing… more
    AdventHealth (08/22/25)
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  • Utilization Review RN - Remote

    Baylor Scott & White Health (Tallahassee, FL)
    …least (3) three years of professional experience is required. + You must hold a valid Registered Nurse License ( RN ). As a health care system committed to ... based on position type and/or level **Job Summary** As the Utilization Review RN you will review patient cases for medical necessity and establish service… more
    Baylor Scott & White Health (08/22/25)
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  • Licensed Practical Nurse - Spine Center…

    Mayo Clinic (Jacksonville, FL)
    …(LPN) provides nursing care to assigned patients under the direct supervision of the registered nurse ( RN ) or other assigned supervisor and accepts ... delegation from the RN /assigned supervisor in meeting the needs of the patient/family....Experience working in a team environment. Computer skills required, prior experience with electronic medical record systems preferred. Ability… more
    Mayo Clinic (08/21/25)
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