• Registered Nurse RN

    AdventHealth (Maitland, FL)
    …**Location** : 600 Courtland, Maitland, FL **The role you'll contribute:** **The Care Transitions Registered Nurse ensures that a care plan is carried out in ... various other teams, including but not limited to Care Management nurses and social workers, nursing, home care liaisons,...State of Florida or multi state license as a Registered Nurse + Basic Life Support (BLS)… more
    AdventHealth (08/07/25)
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  • Clinical Appeals Nurse ( RN )

    Molina Healthcare (Tampa, FL)
    **JOB DESCRIPTION** For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state they reside This position will support ... Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. +… more
    Molina Healthcare (08/02/25)
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  • Case Manager / PRN ( RN / RT / SW / LPN )

    Select Medical (Pensacola, FL)
    … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning,...**Current licensure in a clinical discipline either as a Nurse ( RN /LPN/ LVN)or a Respiratory Therapist… more
    Select Medical (08/02/25)
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  • Case Manager ( RN / RT / SW / LPN )

    Select Medical (Orlando, FL)
    … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... current licensure in a clinical discipline either as a Nurse ( RN /LPN/LVN) or a Respiratory Therapist (RT)...what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning,… more
    Select Medical (07/19/25)
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  • Care Review Clinician, PA ( RN )

    Molina Healthcare (St. Petersburg, 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 (08/08/25)
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  • RN Case Manager PRN

    HCA Healthcare (Sanford, FL)
    …a part of our team. **Job Summary and Qualifications** We are seeking a dynamic Case Management RN to join our team. We need a compassionate and reliable RN ... join an organization that invests in you as an RN Case Manager PRN? At HCA Florida Lake Monroe...patients, families, hospital staff, and outside agencies + Performs utilization management reviews and communicates information to… more
    HCA Healthcare (07/19/25)
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  • RN Case Manager PRN

    HCA Healthcare (Gainesville, FL)
    …knowledge and expertise! **Job Summary and Qualifications** We are seeking a dynamic Case Management RN to join our team. We need a compassionate and reliable ... **Introduction** Do you have the career opportunities as a(an) RN Case Manager PRN you want with your current...patients, families, hospital staff, and outside agencies + Performs utilization management reviews and communicates information to… more
    HCA Healthcare (06/21/25)
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  • Quality Management , Nurse

    CVS Health (Tallahassee, FL)
    …clinical judgement as well as knowledge of internal systems. **Required Qualifications** - Registered Nurse ( RN ) with current unrestricted compact license ... position reports to the Potential Quality of Care (PQOC) nurse investigator team manager. This position is responsible for...care experience - Experience working Grievance cases - Case Management or Utilization Management experience… more
    CVS Health (08/08/25)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Venice, FL)
    …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
    Fresenius Medical Center (07/31/25)
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  • RN Care Manager

    AdventHealth (Deland, FL)
    …expertise and experiences you'll need to succeed: Minimum qualifications: + Associate's degree Nursing or RN Diploma degree + Registered Nurse ( RN ) + Two ... + BSN + Health-related Master's degree or MSN + Prior Care Management / Utilization Management experience ACM/CCM Certification This facility is… more
    AdventHealth (08/07/25)
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