• UM Nurse

    Humana (Tallahassee, FL)
    …caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and ... medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation… more
    Humana (09/04/25)
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  • RN Registered Nurse Utilization Management

    AdventHealth (Tampa, FL)
    …does not align with the physician order or a status conflict is indicated, the UM nurse is responsible for escalation to the Physician Advisor or designated ... **The role you'll contribute:** The role of the Utilization Management ( UM ) Registered Nurse (RN) is to use clinical expertise by analyzing patient records… more
    AdventHealth (09/04/25)
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  • Utilization Management Nurse Consultant…

    CVS Health (Tallahassee, FL)
    …high-quality healthcare for members. We are seeking a dedicated Utilization Management ( UM ) Nurse Consultant to join our remote team. **Key Responsibilities** ... of a computer. + Flexibility to provide coverage for other Utilization Management ( UM ) Nurses across various UM specialty teams as needed, ensuring continuity… more
    CVS Health (09/04/25)
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  • Registered Nurse 2 - Pain Center - Full…

    University of Miami (Miami, FL)
    …this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . JOB DESCRIPTION UM Title: Senior Registered Nurse Supervisor's ... 2014. Job Summary (Purpose and Function): The Pain Management Nurse will be a professional registered nurse ...and variances to the plan of care. Documents in UM Care program intra-procedure assessment of patient condition. Planning… more
    University of Miami (07/02/25)
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  • Compliance UM Coordinator

    Humana (Tallahassee, FL)
    …of our caring community and help us put health first** The Compliance ( UM ) Coordinator 2 issues notice of adverse benefit determination letters for Medicaid line ... ensure adherence to contractual and accreditation requirements. The Compliance ( UM ) Coordinator 2 performs varied activities and moderately complex… more
    Humana (09/04/25)
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  • UM Clinical Reviewer

    Centers Plan for Healthy Living (Margate, FL)
    …For Healthy Living is currently accepting applications for Full Time Registered Nurse without experience. The Utilization Management Clinical Reviewer works within a ... multidisciplinary team to help identify and manage members who are in need of additional care or support in their home to improve their quality of life. Utilization Management Clinical Reviewer will assess and process all authorization requests to determine… more
    Centers Plan for Healthy Living (07/15/25)
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  • Nurse Educator - Medical Simulation…

    University of Miami (Miami, FL)
    …Medical Training Lab at the Gordon Center is currently seeking a full time Nurse Educator - Medical Simulation and Education Lab to work in Miami, FL. The ... Nurse Educator provides clinical education to nursing and patient...per year. Training programs include curricula developed by the UM Gordon Center, and other organizations, such as the… more
    University of Miami (07/24/25)
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  • Advanced Practice Registered Nurse - Human…

    University of Miami (Miami, FL)
    …tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Advanced Practice Registered Nurse Human Genetics Full Time The Advanced ... Practice Registered Nurse (H) (APRN) d elivers medical care to a...needed + Evaluates and diagnoses new patients referred to UM /JMH Genetics + Provides long-term follow-up to diagnosed patients… more
    University of Miami (08/27/25)
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  • Revenue Utilization Review (RUR) Nurse

    Veterans Affairs, Veterans Health Administration (Orlando, FL)
    …integration of VHA and industry best standards. Responsibilities Responsibilities of the RUR Nurse Manager (NM) include, but are not limited, to the following: RUR ... Nurse Manager is accountable to the Consolidated Patient Account...Services, Compliance, Providers, Health Information Management (HIM), Utilization Management ( UM ), and Community Care. Completes 4-6 month orientation to… more
    Veterans Affairs, Veterans Health Administration (09/04/25)
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  • Care Review Clinician, Prior Auth (RN) Pega Float…

    Molina Healthcare (Tampa, FL)
    …this position we are hiring for a float team to support PEGA UM systems throughout multiple states.** **JOB DESCRIPTION** **Job Summary** Molina Healthcare Services ... Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional travel to other Molina offices or… more
    Molina Healthcare (07/12/25)
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