• Utilization Management Nurse

    Actalent (Sunrise, FL)
    Actalent is hiring a Utilization Management Nurse ! Job...+ Clinical review + Utilization review + Utilization management + ... Description The Utilization Management Nurse (UMN) collaborates closely with the interdisciplinary team to...+ Valid Florida Driver's License. + Knowledge of case management and utilization review concepts,… more
    Actalent (07/29/25)
    - Related Jobs
  • Remote Utilization Review

    Actalent (Orlando, FL)
    Job Title: Clinical Review Nurse Job Description As a...care. Essential Skills + Proficiency in utilization management and utilization review + ... Clinical Review Nurse , you will perform concurrent reviews to assess members'...ER, Med-Surge, PACU, etc. + Strong multitasking and time management abilities. + Quick learner with a go-with-the-flow attitude.… more
    Actalent (08/08/25)
    - Related Jobs
  • Utilization Management Nurse

    CVS Health (Tallahassee, FL)
    …work._ **Required Qualifications** + 1 year of varied UM ( utilization management ) experience within an **outpatient** setting, concurrent review or prior ... thorough, independent decisions using clinical judgement. + A Registered Nurse that must hold an unrestricted license in their...+ 1 year of varied UM ( utilization management ) experience within an inpatient, concurrent review more
    CVS Health (07/30/25)
    - Related Jobs
  • Registered Nurse ED Utilization

    AdventHealth (Tampa, FL)
    …designated leader for additional review as determined by department standards. The Utilization Management Nurse is accountable for a designated patient ... **The ro** **le you'll contribute:** The role of the Emergency Department Utilization Management (UM) Registered Nurse (RN) is to use clinical expertise… more
    AdventHealth (08/08/25)
    - Related Jobs
  • Registered Nurse ED Utilization

    AdventHealth (Tampa, FL)
    …designated leader for additional review as determined by department standards. The Utilization Management Nurse is accountable for a designated patient ... diseases. **The role you'll contribute:** The role of the Emergency Department Utilization Management (UM) Registered Nurse (RN) is to use clinical expertise… more
    AdventHealth (08/07/25)
    - Related Jobs
  • Registered Nurse Utilization

    AdventHealth (Tampa, FL)
    …failure, cancer and other diseases. **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse (RN) is to use clinical ... of admission; and when warranted by length of stay, utilization review plan, and/or best practice guidelines,...of critical care nursing experience preferred. 1 years of utilization management experience preferred. This facility is… more
    AdventHealth (08/08/25)
    - Related Jobs
  • Utilization Management Nurse

    CenterWell (Tallahassee, FL)
    …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
    CenterWell (08/08/25)
    - Related Jobs
  • Utilization Management Nurse

    CenterWell (Tallahassee, FL)
    …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Orthopedic procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare… more
    CenterWell (08/02/25)
    - Related Jobs
  • Utilization Review Clinician…

    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 ... and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and… more
    Centene Corporation (07/31/25)
    - Related Jobs
  • Utilization Review Clinician - ABA

    Centene Corporation (Tallahassee, FL)
    …in applied behavioral analytics (ABA). Additional Details: * Department: Behavioral Health Utilization Management * Business Unit: Corporate / Florida * ... assess ABA Treatment Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with providers and healthcare… more
    Centene Corporation (08/02/25)
    - Related Jobs