• Clinical Registered Nurse

    Cognizant (Tallahassee, FL)
    …background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience ... Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
    Cognizant (10/07/25)
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  • Utilization Management Nurse

    Humana (Tallahassee, FL)
    …and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to support ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...PHI / HIPAA information ​Travel: While this is a remote position, occasional travel to Humana's offices for training… more
    Humana (09/12/25)
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  • Behavioral Health Utilization Review…

    Actalent (Fort Lauderdale, FL)
    Utilization Review Nurse Job Description We are seeking a dedicated Utilization Management Nurse (UMN) who will work collaboratively with an ... reports on department activities as assigned. Essential Skills + Utilization management + Behavioral Health + Mental...involving shadowing a team member on-site on Tuesdays and remote shadowing through Teams. Pay and Benefits The pay… 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 requests ... department activities as assigned. Essential Skills + Experience in utilization management , behavioral health, and mental health....on Tuesdays and will be logged into Teams for remote shadowing. Job Type & Location This is a… more
    Actalent (10/10/25)
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  • Associate Manager, Clinical Health Services…

    CVS Health (Tallahassee, FL)
    …+ 5+ 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...Weekly Hours: 40 + Travel: While this is a remote position, occasional travel to Humana's offices for training… more
    Humana (09/12/25)
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  • Disease Management Nurse

    Sharecare (Tallahassee, FL)
    …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
    Sharecare (09/13/25)
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  • Case Manager, Registered Nurse - Fully…

    CVS Health (Tallahassee, FL)
    …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... each and every day. **Position Summary** **This is a remote work from home role anywhere in the US...Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator… more
    CVS Health (10/15/25)
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  • Registered Nurse , Remote Triage,…

    ChenMed (Miami, FL)
    …expanding and we need great people to join our team. The Registered Nurse , Remote Triage, is responsible for providing telephonic triage directional patient ... client counseling, patient advocacy, health education and referral and resource management to ChenMed patients and their families. Providing on-call coverage, the… more
    ChenMed (09/17/25)
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  • Utilization Review Clinician - Behavioral…

    Centene Corporation (Tallahassee, FL)
    …28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive ... Analyzes BH member data to improve quality and appropriate utilization of services + Provides education to providers members...Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required… more
    Centene Corporation (10/16/25)
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