• 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 (07/12/25)
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  • Utilization Review Clinician - ABA

    Centene Corporation (Tallahassee, FL)
    …in applied behavioral analytics (ABA). Additional Details: * Department: Behavioral Health Utilization Management * Business Unit: Corporate / Florida * ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
    Centene Corporation (08/02/25)
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  • Utilization Review Clinician - Behavioral…

    Centene Corporation (Tallahassee, FL)
    …be located in eastern or central time zone with experience in utilization management .** **Education/Experience:** Requires Graduate of an Accredited School ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
    Centene Corporation (07/31/25)
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  • Registered Nurse - Remote

    ChenMed (Miami, 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 (06/18/25)
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  • Infusion Referral Nurse - REMOTE

    Prime Therapeutics (Tallahassee, FL)
    …and drives every decision we make. **Job Posting Title** Infusion Referral Nurse - REMOTE **Job Description** Under supervision, is responsible for performing ... Nursing + Bachelors - Nursing + RN - Registered Nurse , State and/or Compact State Licensure - Care Mgmt...experience. + Experience in managed care, specialty drugs, care management and utilization review. + Meets Credentialing… more
    Prime Therapeutics (07/24/25)
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  • Clinical Review Nurse (RN) - Remote

    Actalent (Miami, FL)
    …to assist each other and complete cases. Qualifications: + 2+ years of utilization management , concurrent review, prior authorization, utilization review, ... Urgent Hiring for " Remote Clinical Review Nurses" Job Description: + Review...or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to… more
    Actalent (08/01/25)
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  • Prior Authorization Nurse

    Actalent (Sunrise, FL)
    Utilization Management Nurse !Job Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing service authorization ... activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management ...involving shadowing a team member on-site on Tuesdays and remote shadowing via Teams. Pay and Benefits The pay… more
    Actalent (07/26/25)
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  • Clinical Review Nurse

    Actalent (Orlando, FL)
    …ensure the successful completion of cases. Essential Skills + Experience in utilization management , concurrent review, prior authorization, utilization ... Job Title: Clinical Review NurseJob Description: The Review Nurse will be responsible for reviewing approximately 20...Compact RN License, Compact LPN is okay too + Utilization Management /Concurrent Review experience. + ICU/ER experience.… more
    Actalent (08/02/25)
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  • Case Manager Registered Nurse - Specialty…

    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...Pharmacy or Oncology.** **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator… more
    CVS Health (07/31/25)
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  • Registered Nurse , Case Manager…

    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...using a keyboard **Preferred Qualifications** - 1+ years' Case Management experience or discharge planning, nurse navigator… more
    CVS Health (07/31/25)
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