• Parexel (Tallahassee, FL)
    …mitigations and drive resolution with cross-functional stakeholders as part of the Risk Management Plan. + Review and analyze metrics to derive meaningful ... practices like version control and literate programming. + BSN, RN , RPh, Pharm D, PA, MPH, or other applicable...project-level resourcing of staff and staff assignments. + Regularly review and update Data Management resources to… more
    DirectEmployers Association (10/10/25)
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  • Associate Manager, Clinical Health Services…

    CVS Health (Tallahassee, 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 (10/15/25)
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  • SNF Utilization Management RN…

    Humana (Tallahassee, FL)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **​Licensed Registered Nurse ( RN )** in the… more
    Humana (09/12/25)
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  • ED Utilization Management…

    AdventHealth (Tampa, FL)
    …contribute:** The role of the Emergency Department Utilization Management (UM) Registered Nurse ( RN ) is to use clinical expertise by analyzing ... review as determined by department standards. The Utilization Management Nurse is accountable...electronic health records of at least two years Preferred RN - Registered Nurse -… more
    AdventHealth (10/11/25)
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  • Clinical Registered Nurse…

    Cognizant (Tallahassee, FL)
    …have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
    Cognizant (10/07/25)
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  • Behavioral Health Utilization Review…

    Actalent (Fort Lauderdale, FL)
    Actalent is Hiring a Behavioral Health Utilization Review Nurse Job Description We are seeking a dedicated Utilization Management Nurse (UMN) who ... Additional Skills & Qualifications + Current unrestricted Florida RN or LPN License. + Minimum of one year...+ Valid Florida Driver's License. + Knowledge of case management and utilization review concepts,… more
    Actalent (10/15/25)
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  • Behavioral Health Utilization Review…

    Actalent (Sunrise, FL)
    Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing ... health. + Proficiency in clinical and utilization review processes. + Current unrestricted Florida RN ...+ Valid Florida Driver's License. + Knowledge of case management and utilization review concepts,… more
    Actalent (10/10/25)
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  • Inpatient Nurse Reviewer

    DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
    …safe discharge coverage for all hospital units. + Participates in utilization management initiatives/opportunities for improvement through departmental committee ... assignments. Qualifications: + Registered Nurse , Licensed Practical Nurse ...Florida. + 3 years minimum experience in discharge planning, utilization management , or case management .… more
    DOCTORS HEALTHCARE PLANS, INC. (10/16/25)
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  • UM Clinical Reviewer

    Centers Plan for Healthy Living (Margate, FL)
    …applications for Full Time Registered Nurse without experience. The Utilization Management Clinical Reviewer works within a multidisciplinary team to ... in their home to improve their quality of life. Utilization Management Clinical Reviewer will...education, and preventative interventions are maintained. Qualifications: + Active RN license, entry level RN welcome +… more
    Centers Plan for Healthy Living (10/14/25)
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  • Registered Nurse Care Manager

    AdventHealth (Orlando, FL)
    …documents avoidable days, and facilitates progression of care. Collaborates with Utilization Management staff for collaboration on patient status changes ... valid State of Florida or multistate license as a Registered Nurse + 2 years of medical/...+ Health-related masters degree or MSN + Prior Care Management / Utilization Management experience +… more
    AdventHealth (10/06/25)
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