• Hybrid Clinical Review Nurse

    Actalent (Sunrise, FL)
    Utilization Management Nurse !Job Description The ...on department activities as assigned. Essential Skills + Clinical review + Utilization review + ... record Additional Skills & Qualifications + Current unrestricted Florida RN or LPN License. + Minimum of one year...or LPN License. + Minimum of one year of utilization review experience and discharge planning in… more
    Actalent (08/09/25)
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  • Clinical Review Nurse

    Actalent (Orlando, FL)
    …Active Compact RN License, Compact LPN is okay too + Utilization Management/Concurrent Review experience. + ICU/ER experience. + Strong communication skills. ... Job Title: Clinical Review NurseJob Description: The Review Nurse will be responsible for reviewing...Skills + Experience in utilization management, concurrent review , prior authorization, utilization review ,… more
    Actalent (08/02/25)
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  • Clinical Health Services Associate Manager

    CVS Health (Tallahassee, FL)
    …in state of residence + 5+ years of acute experience as a Registered Nurse + 3+ years of Utilization Management experience + Must have experience using MS ... And we do it all with heart, each and every day. **Position Summary** Fully remote , Monday-Friday 8am - 5pm EST position (shifts may vary based on business needs)… more
    CVS Health (08/08/25)
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  • Telephonic Behavior Health Care Manager

    Humana (Hallandale Beach, FL)
    …+ Bachelor's degree in social work or behavioral health-related field + Active licensed Registered Nurse , RN in the state of Florida without disciplinary ... and requirements to achieve and/or maintain optimal wellness state in a remote telephonic environment. The Behavioral Health Care Manager guides members and/or… more
    Humana (07/15/25)
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  • Permanent Partial Disability (PPD) Consultant

    The Hartford (Lake Mary, FL)
    …PPD and assist with claim settlement strategies as needed Qualifications: + Registered Nurse , Occupational Therapist, Physical Therapist or other related ... PPD rules and requirements, claim management, case management, and/or utilization review methodology preferred + Excellent verbal...Information: + This role can have a Hybrid or Remote work arrangement. Candidates who live near one of… more
    The Hartford (08/13/25)
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  • Trainer-Auditor (Clinical)

    Centene Corporation (Tallahassee, FL)
    …in eastern or central time zones. Ideal candidate will have experience in utilization review and 1+ years of auditing.** **Education/Experience:** Associate's or ... managed care or healthcare setting. Amisys and CCMS experience preferred. **License/Certification:** RN or LPN license. Pay Range: $55,100.00 - $99,000.00 per year… more
    Centene Corporation (07/18/25)
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