• Home Care Supervisor, RN

    BayCare Health System (Bradenton, FL)
    …the area of responsibility. + Ensure quality assurance program and utilization review is followed in accordance with Home Care protocol. + Oversees and ... Participates with Case Manager on initial Plan of Care review with a focus on quality, utilization ...Knowledge of regulatory standards appropriate to position. **Requirements:** + RN ( Registered Nurse ) License +… more
    BayCare Health System (11/20/25)
    - Related Jobs

  • Home Care Supervisor, RN

    BayCare Health System (Dunedin, FL)
    …within the area of responsibility + Ensure quality assurance program and utilization review is followed in accordance with Home Care protocol + Oversees and ... Participates with Case Manager on initial Plan of Care review with a focus on quality, utilization ...Health RN visit experience. **Required Credentials:** + RN ( Registered Nurse ) License +… more
    BayCare Health System (10/10/25)
    - Related Jobs

  • SNF Utilization Management RN…

    Humana (Tallahassee, FL)
    …an impact** **Use your skills to make an impact** **Required Qualifications** + **​Licensed Registered Nurse ( RN )** in the (appropriate state) with no ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing...in an acute care setting + Previous experience in utilization management/ utilization review for a… more
    Humana (12/12/25)
    - Related Jobs

  • Utilization Review Team Lead

    BayCare Health System (St. Petersburg, FL)
    … Management or 6 years of clinical nursing **Certifications and Licensures:** + Required RN ( Registered Nurse ) + Preferred ACM (Case Management) + Preferred ... trust, dignity, respect, responsibility and clinical excellence. **The Team Lead Utilization Review responsibilities include:** + Directing and coordinating the… more
    BayCare Health System (11/12/25)
    - Related Jobs

  • RN Clinical Manager, Home Health

    CenterWell (Madison, FL)
    …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
    CenterWell (12/10/25)
    - Related Jobs

  • RN Clinical Manager, Home Health

    CenterWell (Ocala, FL)
    …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
    CenterWell (11/20/25)
    - Related Jobs

  • Utilization Management Nurse

    CenterWell (Tallahassee, FL)
    …community and help us put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that focuses on excellent… more
    CenterWell (11/22/25)
    - Related Jobs

  • Care Review Clinician ( RN )

    Molina Healthcare (Orlando, FL)
    For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet ... (Team will work on set schedule) Looking for a RN with experience with appeals, claims review ,...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/23/25)
    - Related Jobs

  • RN Case Manager PRN

    HCA Healthcare (Orange Park, FL)
    **Description** **Introduction** Do you have the PRN career opportunities as a ** Registered Nurse ( RN ) Case Manager** you want with your current employer? We ... expertise! **Job Summary and Qualifications** We are seeking a Registered Nurse ( RN ) Case Manager...this PRN position. + Certification in Case Management or Utilization Review is preferred. + InterQual experience… more
    HCA Healthcare (12/03/25)
    - Related Jobs

  • 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 - Currently licensed as a...opportunity compelling, we encourage you to apply for our RN Case Manager PRN opening. We promptly review… more
    HCA Healthcare (11/10/25)
    - Related Jobs