• Hybrid Clinical Review Nurse

    Actalent (Sunrise, FL)
    Utilization Management Nurse !Job Description The ...on department activities as assigned. Essential Skills + Clinical review + Utilization review + ... Working under the general supervision of the Director and/or Manager /Supervisor of Medical Management, and in collaboration with an...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 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 ... team is producing at a successful level. The Associate Manager is also responsible for oversight of utilization...other key business areas. + May develop/assist in development and/ review new training content. + May collaborate/deliver inter and… more
    CVS Health (08/08/25)
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  • Manager Case Management

    HCA Healthcare (Tallahassee, FL)
    …options and costs to patient and patient families. **What qualifications you will need:** + Registered Nurse , or Advance Practice Registered Nurse (APRN) ... Performs admission certification screening for patients in accordance with Utilization Plan using ISD criteria, and performs concurrent stay...career path, we encourage you to apply for our Manager Case Management opening. We review all… more
    HCA Healthcare (07/18/25)
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  • Nurse Manager - UHealth Palmetto Bay

    University of Miami (Miami, FL)
    …necessary. Core Qualifications: Education: Bachelor's degree in nursing Certification and Licensing: Registered Nurse Licensure ( RN ) State of Florida ... . The University of Miami/UHealth Palmetto Bay has an exciting opportunity for a Nurse Manager . The Manager , Nursing promotes and restores patients' health… more
    University of Miami (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 ... company and members are optimized. The Telephonic Behavioral Health Care Manager Internship provides transitioning service members that are eligible to participate… more
    Humana (07/15/25)
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  • Manager Case Management

    HCA Healthcare (Ocala, FL)
    …and costs to patient and patient families. What qualifications you will need: + Registered Nurse + Associate Degree HCA Florida Ocala Hospital is a 323-bed ... provides satisfaction and personal growth, we encourage you to apply for our Manager Case Management opening. We promptly review all applications. Highly… more
    HCA Healthcare (06/21/25)
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  • Clinical Coding and OASIS Review

    BAYADA Home Health Care (Orlando, FL)
    …Home Health Care has an immediate opening for a **Full Time,** OASIS and Coding Review Manager with OASIS and Coding certification to work remotely. RN , ... your career with an industry leader. Apply now for immediate consideration. OASIS Review , Utilization Review , Quality Assurance, Remote, Home Health Coding,… more
    BAYADA Home Health Care (07/01/25)
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  • Case Manager - UM II -100%

    Healthfirst (FL)
    The Case Manager , Utilization Management coordinates the care plan for assigned members and conducts pre-certification, concurrent review , discharge ... planning, and case management as assigned. The Case Manager , Utilization Management is also responsible for...necessary + Additional duties as assigned Minimum Qualifications: + RN , LPN, LMSW, LMHC, LMFT, LCSW, PT, OT, and/or… more
    Healthfirst (08/08/25)
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  • Infusion Referral Nurse - REMOTE

    Prime Therapeutics (Tallahassee, FL)
    …Patient Programs. **Education & Experience** + Associates - Nursing + Bachelors - Nursing + RN - Registered Nurse , State and/or Compact State Licensure - ... for work visa or residency sponsorship. **Additional Qualifications** + Registered Nurse ( RN ). + 5...Experience in managed care, specialty drugs, care management and utilization review . + Meets Credentialing criteria. +… more
    Prime Therapeutics (07/24/25)
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  • Nurse - Community Care Community Health

    Veterans Affairs, Veterans Health Administration (Winter Park, FL)
    …well as customer service programs. Responsibilities The Community Care (CC) Community Health Registered Nurse ( RN ) is responsible for executing a streamlined ... intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
    Veterans Affairs, Veterans Health Administration (08/08/25)
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