• Oncology Prior Authorization Case…

    University of Miami (Miami, FL)
    …Department of UMHC SCCC Business Operations has an exciting opportunity for a full time Utilization Review Case Manager to work to work remote. The incumbent ... chart reviews for clinical utilization and authorization. The Utilization Review Case Manager coordinates with the healthcare team for optimal… more
    University of Miami (09/25/25)
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  • Oncology Prior Authorization Case…

    University of Miami (Miami, FL)
    …worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Utilization Review Case Manager RN ... Time The University of Miami is currently seeking a Prior Authorization Nurse Case Manager . The incumbent purose is to conduct initial chart reviews for medical… more
    University of Miami (08/23/25)
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  • Clinical Learning Facilitator - Utilization…

    Molina Healthcare (St. Petersburg, FL)
    …Active, unrestricted State RN or Clinical Social Worker/Counseling License. + Certified Case Manager (CCM), Utilization Management Certification (CPHM), ... or state board licensing mandate. + At least 2 years in case , disease or utilization management; managed care; or medical/behavioral health settings. + One year… more
    Molina Healthcare (09/17/25)
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  • RN Case Manager - Case…

    Mayo Clinic (Jacksonville, FL)
    …care coordination, resource utilization , and clinical documentation. The RN Case Manager will function within the Mayo Clinical Nursing Professional ... Case Manager provides leadership through education on case management/ utilization management concepts, committee work, research, and community… more
    Mayo Clinic (09/07/25)
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  • Case Manager / PRN ( RN / RT / SW…

    Select Medical (Tallahassee, FL)
    …ideas, providing high-quality care and doing well by doing what is right. The Case Manager is responsible for utilization reviews and resource management, ... **Overview** **Critical Illness Recovery Hospital** ** Case Manager (PRN)** _Requires a current...safe and timely discharge plan. + Performs verification of utilization criteria reviews. + Builds relationships and coordinate with… more
    Select Medical (10/01/25)
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  • Case Manager ( RN / RT / SW / LPN )

    Select Medical (Fort Myers, FL)
    …ideas, providing high-quality care and doing well by doing what is right. The Case Manager is responsible for utilization reviews and resource management, ... **Overview** **Critical Illness Recovery Hospital** ** Case Manager ** _Requires a current licensure...safe and timely discharge plan. + Performs verification of utilization criteria reviews. + Builds relationships and coordinate with… more
    Select Medical (09/13/25)
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  • Behavioral Health Utilization Review Nurse

    Actalent (Sunrise, FL)
    …Skills & Qualifications + Valid Florida Driver's License. + Knowledge of case management and utilization review concepts, including InterQual and Milliman ... Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization ...services. Under the general supervision of the Director and/or Manager /Supervisor of Medical Management, and in collaboration with the… more
    Actalent (10/02/25)
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  • Pharmacist, Utilization Management (UM)…

    Molina Healthcare (Orlando, FL)
    …(such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services ... and quality initiatives under the direction of leadership. + Monitors drug utilization and assists leadership team in understanding quality and cost control issues… more
    Molina Healthcare (09/25/25)
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  • RN Case Manager PRN

    HCA Healthcare (Tallahassee, FL)
    …Do you want to join an organization that invests in you as a(an) RN Case Manager PRN? At HCA Florida Capital Hospital, you come first. HCA Healthcare ... a difference. We are looking for a dedicated RN Case Manager PRN like you to be...for position if current and compliant** + **Certification in Case Management, Nursing, or Utilization Review, preferred**… more
    HCA Healthcare (09/19/25)
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  • RN Case Manager

    HCA Healthcare (Tallahassee, FL)
    **Description** **Introduction** Do you have the career opportunities as a RN Case Manager you want in your current role? We invest in what matters most to ... for position if current and compliant** + **Certification in Case Management, Nursing, or Utilization Review, preferred**...path, we encourage you to apply for our RN Case Manager opening. We review all applications.… more
    HCA Healthcare (09/21/25)
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