- Community Health Systems (Naples, FL)
- …401k match & more available for Full and Part-Time roles **Job Summary** The Utilization Review Nurse - RN reviews hospital admissions, extended stays, ... Join us as a **Registered Nurse (RN) - Utilization Review position** at Physicians Regional Collier Unit: Utilization Review Shift: Mon-Fri (this is… more
- 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 in ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...as well as timely filing deadlines and processes. + Review clinical denials including but not limited to referral,… more
- BayCare Health System (Tampa, FL)
- …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN responsibilities include:** + Functions ... Call:** No **Certifications and Licensures:** + Required RN (Registered Nurse ) + Preferred ACM (Case Management) + Preferred CCM...Nursing or Business **Experience:** + Required 2 years in Utilization Review or + Required 2 years… more
- Humana (Tallahassee, FL)
- …Coordinator or discharge planner in an acute care setting + Previous experience in utilization management/ utilization review for a health plan or acute care ... our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination,… more
- Elevance Health (Jacksonville, FL)
- …prior authorization, and post service requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification ... **Title: Utilization Management Representative I** **Virtual:** This role enables...responsible for coordinating cases for precertification and prior authorization review . **How you will make an impact:** + Managing… more
- Elevance Health (Miami, FL)
- …Finder and follows up with provider on referrals given. + Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care. + ... ** Utilization Management Representative II** **Virtual:** This role enables...Processes incoming requests, collection of information needed for review from providers, utilizing scripts to screen basic and… more
- MyFlorida (Port Charlotte, FL)
- SENIOR REGISTERED NURSE SUPV - 50009026 Date: Dec 19, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... No: 865480 Agency: Veterans Affairs Working Title: SENIOR REGISTERED NURSE SUPV - 50009026 Pay Plan: Career Service Position...that the residents are receiving total nursing care. + Review shift assignments and ensure that the assignments reflect… more
- MyFlorida (Land O' Lakes, FL)
- SENIOR LICENSED PRACTICAL NURSE - 50000083 Date: Dec 12, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... Requisition No: 865263 Agency: Veterans Affairs Working Title: SENIOR LICENSED PRACTICAL NURSE - 50000083 Pay Plan: Career Service Position Number: 50000083 Salary:… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …+ Participate in interdisciplinary case rounds, quality improvement initiatives, and utilization review processes. + Support members during transitions of ... Position is On-Site The Behavioral Health Nurse - Managed Care is responsible for coordinating,...+ Experience in a managed care, case management, or utilization review setting + Strong understanding of… more
- HCA Healthcare (Kissimmee, FL)
- …and improve the patient flow program effectiveness as it relates to utilization review , resource management, and discharge planning and care coordination. ... leader to physicians and employees as it relates to utilization review , resource management, patient flow, multi-disciplinary...30 days of employment start date + (RN) Registered Nurse + Associate Degree, or Bachelors Degree Preferred HCA… more