- Molina Healthcare (Orlando, FL)
- For this position we are seeking a ( RN ) Registered Nurse who...for a RN with experience with appeals, claims review , and medical coding. ... authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted… more
- MyFlorida (Orlando, FL)
- …that all verbal orders, including telephone orders from attending physicians, are reviewed by a registered nurse . + If no RN is available, receive all ... reflective of resident's status, and providing supervision and guidance to the Registered ( RN ), Licensed Practical Nurse (LPN), Certified Nursing… more
- Cognizant (Tallahassee, FL)
- …expectations. **What you need to have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...the medical necessity determinations to the Health Plan/ Medical Director based on the review of… more
- MyFlorida (Orlando, FL)
- REGISTERED NURSE Date: Nov 2, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 860343 Agency: Veterans Affairs Working Title: REGISTERED NURSE Pay Plan: Career Service Position Number:… more
- MyFlorida (Port Saint Lucie, FL)
- REGISTERED NURSE Date: Oct 29, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 864225 Agency: Veterans Affairs Working Title: REGISTERED NURSE Pay Plan: Career Service Position Number:… more
- MyFlorida (Panama City, FL)
- OPS REGISTERED NURSE WW - 50601394 Date: Nov 20, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... Requisition No: 865710 Agency: Veterans Affairs Working Title: OPS REGISTERED NURSE WW - 50601394 Pay Plan:...history must be verifiable. Please attach any credentials you claim (degrees, certifications, etc.) to your application. ** Other… more
- CVS Health (Tallahassee, FL)
- …however, it is subject to change based on business needs.** The RN Case Manager is responsible for telephonically assessing, planning, implementing, and coordinating ... all case management activities with members to evaluate the medical needs of the member and to help facilitate...- Through the use of clinical tools and information/data review , conducts an evaluation of member's needs and benefit… more
- Elevance Health (Tampa, FL)
- …and abuse prevention and control. + Review and conducts analysis of claims and medical records prior to payment. Researches new healthcare-related questions ... **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon...Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Clinical Fraud Investigator II** is responsible… more
- AdventHealth (Riverview, FL)
- …business or healthcare related field 3 years clinical experience in healthcare related field Registered Nurse ( RN ) This facility is an equal opportunity ... be caring for:** AdventHealth Riverview AdventHealth is expanding our medical expertise, innovation, and state-of-the-art technology to southern Hillsborough County… more
- Molina Healthcare (Orlando, FL)
- …managed care experience in the specific programs supported by the plan such as utilization review , medical claims review , long-term services and supports ... likelihood of a formal appeal being submitted. * Reevaluates medical claims and associated records independently by...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more