• RN Case Manager

    HCA Healthcare (Fort Walton Beach, FL)
    …Case Management is preferred + BSN is preferred + Certification in Case Management , Nursing or Utilization Review is preferred HCA Florida Fort ... join an organization that invests in you as a(an) RN Case Manager Evenings? At HCA Florida Fort Walton-Destin...patients, families, hospital staff, and outside agencies + Performs utilization management reviews and communicates information to… more
    HCA Healthcare (10/01/25)
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  • Associate Manager, Clinical Health Services…

    CVS Health (FL)
    …years of acute experience as a Registered Nurse + 3+ years of Utilization Management experience + 3+ year(s) of Appeals experience in Utilization ... members. **Position Summary** The Associate Manager is responsible for oversight of Utilization Management staff. This position is responsible for the… more
    CVS Health (10/08/25)
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  • Director of Case Management ( RN…

    Select Medical (Oxford, FL)
    …Illness Recovery Hospital** **Director of Case Management ** **_Clinical license as a registered nurse or respiratory therapist or master's in social work and ... functions and professional growth of the department, including, but not limited to: Utilization Review (UR) and resource management , discharge planning,… more
    Select Medical (10/03/25)
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  • Quality Review Nurse RN PRN…

    AdventHealth (Orlando, FL)
    **Quality Review Nurse RN PRN Home Care AdventHealth Home Health** **All the benefits and perks you need for you and your family:** + Benefits from Day One + ... 32804 **The role you'll contribute:** Responsible for ensuring effective utilization and case management oversight activities as...Care experience + OASIS experience + PDGM experience + Registered Nurse State Licensure and/or Compact State… more
    AdventHealth (10/09/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (FL)
    …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. **Required Qualifications** * At… more
    Molina Healthcare (10/02/25)
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  • RN Case Manager NE BU

    Cleveland Clinic (Vero Beach, FL)
    …include: + Bachelor of science in nursing (BSN) + Current state licensure as a Registered Nurse ( RN ) + Basic Life Support (BLS) certification through the ... of the most respected healthcare organizations in the world. RN Case Managers work collaboratively with inter-professional teams across...or AHA) + 2 years of recent experience in utilization review , quality or care management… more
    Cleveland Clinic (10/08/25)
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  • RN Case Manager NE

    Cleveland Clinic (Port Saint Lucie, FL)
    …school of professional nursing (ADN or BSN program) + Current state licensure as a Registered Nurse ( RN ) + Basic Life Support (BLS) certification through the ... of the most respected healthcare organizations in the world. RN Case Managers work collaboratively with inter-professional teams across...or AHA) + Two years of recent experience in utilization review , quality or care management… more
    Cleveland Clinic (09/27/25)
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  • RN Case Manager PRN

    HCA Healthcare (Kissimmee, FL)
    …patient safety.​ + ​Other duties as assigned.​ **What qualifications you will need:** + ( RN ) Registered Nurse + Associate Degree + Bachelor's in Nursing ... + 1+ year of prior case management experience + Registered Nurse ...opportunity compelling, we encourage you to apply for our RN Case Manager PRN opening. We promptly review… more
    HCA Healthcare (08/28/25)
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  • Medical Claim Review Nurse…

    Molina Healthcare (Tampa, FL)
    …of payment decisions. + Serves as a clinical resource for Utilization Management , Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. ... SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years… more
    Molina Healthcare (09/06/25)
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  • RN - Care Management PRN

    AdventHealth (Land O' Lakes, FL)
    …for one another and respect for each persons unique contributions, provides utilization review care that is non-judgmental and non-discriminatory. Consider ... specific group of patients.The Case Manager is responsible for utilization reviews and resource management , discharge planning,...(2) years of hospital nursing experience .Current license of registered nurse in Florida or licensure from… more
    AdventHealth (08/07/25)
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