• Clinical Reviewer, Nurse - 9am -6pm PST

    Evolent (Tallahassee, FL)
    …for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are ... quality and cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on call… more
    Evolent (08/21/25)
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  • Registered Nurse RN case Mgr

    HCA Healthcare (Margate, FL)
    …+ Experience or 2 years of critical care experience + Certification in case management or utilization review preferred + InterQual experience preferred + This ... Do you have the career opportunities as a(an) Registered Nurse RN case Mgr you want with your current...collaborates with the Rehab Program Director and Facility Case Management Director regarding departmental functions. The CM coordinates efforts… more
    HCA Healthcare (08/15/25)
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  • Registered Nurse Case Mgr RN PRN

    HCA Healthcare (Aventura, FL)
    …experience or 2 years of critical care experience + Certification in case management or utilization review preferred + InterQual experience preferred HCA Florida ... colleagues invested over 156,000 hours volunteering in our communities. As a(an) Registered Nurse Case Mgr RN PRN with HCA Florida Aventura Hospital you can be… more
    HCA Healthcare (08/09/25)
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  • Psychiatric Mental Health Nurse

    Florida Health Care Plans, Inc. (Daytona Beach, FL)
    …Details * Evaluation, assessment, and treatment of Behavioral Health patients * Case Management functions * Utilization Management functions. * Special ... a large multi-specialty staff model HMO, is seeking a Psychiatric Mental Health Nurse Practitioner, (PMHNP) to join our Behavioral Health Team in our Edgewater… more
    Florida Health Care Plans, Inc. (08/17/25)
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  • Telephonic Nurse Case Manager II

    Elevance Health (Miami, FL)
    …required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care ... **Telephonic Nurse Case Manager II** **Location: This role enables...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
    Elevance Health (08/14/25)
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  • Senior Nurse Manager Med Surg Medical Unit…

    AdventHealth (Davenport, FL)
    …without being located in the central hub of tourism. **The role you'll contribute:** The Nurse Manager (NM) is a registered professional nurse who has the most ... interprets unit-department based budgeting. Maintains staffing and scheduling, and resource utilization within budgeted targets for the unit. Sets quality standards… more
    AdventHealth (08/09/25)
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  • Registered Nurse , ER, Emergency Triage-…

    ChenMed (Jacksonville, FL)
    …expanding and we need great people to join our team. The Registered Nurse , Telehealth is responsible for providing telephonic triage directional patient care advice ... issues, client counseling, patient advocacy, health education and referral and resource management to ChenMed patients and their families. The incumbent in this role… more
    ChenMed (08/08/25)
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  • Registered Nurse RN Transition Specialist…

    AdventHealth (Maitland, FL)
    …: 600 Courtland, Maitland, FL **The role you'll contribute:** **The Care Transitions Registered Nurse ensures that a care plan is carried out in partnership with the ... various other teams, including but not limited to Care Management nurses and social workers, nursing, home care liaisons,...high risk for readmission or for high emergency room utilization . Follows up with patients at location of post… more
    AdventHealth (08/16/25)
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  • RN Registered Nurse Care Manager PRN

    AdventHealth (Tampa, FL)
    …patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the interdisciplinary team ... core competencies of this role. The RN Care Manager facilitates the collaborative management of patient care across the continuum, intervening to remove barriers to… more
    AdventHealth (08/07/25)
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  • Appeals Registered Nurse

    Evolent (Tallahassee, FL)
    …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... **What You Will Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company policies and… more
    Evolent (08/08/25)
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