• Care Review Clinician, Prior Auth ( RN

    Molina Healthcare (Tampa, FL)
    …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more
    Molina Healthcare (07/12/25)
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  • Registed Nurse - Medical ICU, Charge…

    Community Health Systems (Naples, FL)
    …problem-solving skills for addressing unit challenges and emergencies. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or ... repayment plan ** Comprehensive benefits (Medical, Dental, Vision) **Job Summary** The RN Charge oversees the operations of a nursing unit during assigned shifts,… more
    Community Health Systems (07/12/25)
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  • Assistant Nurse Manager RN Float…

    AdventHealth (Daytona Beach, FL)
    …+ Associate or Diploma in Nursing from an accredited school + Current Florida Registered Nurse license + Current Basic Life Support (BLS) certification + Current ... 32117 **The role you'll contribute:** The ANM is a registered professional nurse who supports the ...of the budget. Maintains staffing and scheduling, and resource utilization within budgeted targets for the unit. + Collaborates… more
    AdventHealth (08/07/25)
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  • Utilization Review Specialist Sr.

    BayCare Health System (Tampa, FL)
    …Call:** No **Certifications and Licensures:** + Required RN ( Registered Nurse ) + Preferred ACM (Case Management ) + Preferred CCM (Case Manager) ... or + Required 2 years in Case Management or + Required 3 years Registered Nurse + Preferred experience in Critical Care or Emergency Service **Benefits:** +… more
    BayCare Health System (08/26/25)
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  • Utilization Review Spec Sr

    BayCare Health System (Clearwater, FL)
    …Call:** No **Certifications and Licensures:** + Required RN ( Registered Nurse ) + Preferred ACM (Case Management ) + Preferred CCM (Case Manager) ... or + Required 2 years in Case Management or + Required 3 years Registered Nurse + Preferred experience in Critical Care or Emergency Service **Benefits:** +… more
    BayCare Health System (08/22/25)
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  • Assistant Nurse Manager RN

    AdventHealth (Tavares, FL)
    …+ Associate or Diploma in Nursing from an accredited school + Current Florida Registered Nurse license + Current Basic Life Support (BLS) certification + Current ... 32778 **The role you'll contribute:** The ANM is a registered professional nurse who supports the ...of the budget. Maintains staffing and scheduling, and resource utilization within budgeted targets for the unit. + **Technology**… more
    AdventHealth (08/07/25)
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  • Clinical Appeals Nurse ( RN )

    Molina Healthcare (Tampa, FL)
    …Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + ... as may be required. + Serves as a clinical resource for Utilization Management , Chief Medical Officer, Physicians, and Member/Provider Inquiries/Appeals. +… more
    Molina Healthcare (08/15/25)
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  • Utilization Review Clinician - ABA

    Centene Corporation (Tallahassee, FL)
    …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... in applied behavioral analytics (ABA). Additional Details: * Department: Behavioral Health Utilization Management * Business Unit: Corporate / Florida *… more
    Centene Corporation (08/23/25)
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  • Utilization Review Clinician - Behavioral…

    Centene Corporation (Tallahassee, FL)
    …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... be located in eastern or central time zone with experience in utilization management .** **Education/Experience:** Requires Graduate of an Accredited School… more
    Centene Corporation (07/31/25)
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  • RN Case Manager

    HCA Healthcare (Kissimmee, FL)
    …like you to be a part of our team. **Job Summary and Qualifications** ​​The Registered Nurse ( RN ) CM is responsible for promoting patient-centered care by ... supporting a balance of optimal care and appropriate resource utilization .​ + ​Provides case management services for...**What qualifications you will need:** + (APRN) Advanced Practice Registered Nurse , or ( RN ) … more
    HCA Healthcare (08/09/25)
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