• Behavioral Health Utilization Review

    Actalent (Sunrise, FL)
    Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing requests ... the interdisciplinary team, the UMN handles tasks related to utilization review across various specialties, medical treatments,...health. + Proficiency in clinical and utilization review processes. + Current unrestricted Florida RN more
    Actalent (10/04/25)
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  • Utilization Review RN

    BayCare Health System (Tampa, FL)
    …appraisals + Community discounts and more Equal Opportunity Employer Veterans/Disabled **Position** Utilization Review RN **Location** Tampa:St Josephs | ... of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/ RN responsibilities...+ **On Call:** No **Certifications and Licensures:** + Required RN ( Registered Nurse ) + Preferred… more
    BayCare Health System (10/10/25)
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  • Utilization Review Clinician…

    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 ... and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and… more
    Centene Corporation (10/01/25)
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  • Utilization Management Registered

    AdventHealth (Daytona Beach, FL)
    …32117 **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse ( RN ) is to use clinical expertise by analyzing patient ... of admission; and when warranted by length of stay, utilization review plan, and/or best practice guidelines,...+ Current and valid license to practice as a Registered Nurse (ADN or BSN) required. +… more
    AdventHealth (09/18/25)
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  • SNF Utilization Management RN

    Humana (Tallahassee, FL)
    …an impact** **Use your skills to make an impact** **Required Qualifications** + **​Licensed Registered Nurse ( RN )** in the (appropriate state) with no ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing...in an acute care setting + Previous experience in utilization management/ utilization review for a… more
    Humana (09/12/25)
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  • Medical Claim Review Nurse

    Molina Healthcare (Tampa, FL)
    …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... hours 6 AM to 6 PM (Team will work on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing… more
    Molina Healthcare (09/06/25)
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  • Care Review Clinician, PA ( RN )

    Molina Healthcare (Orlando, 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 (09/05/25)
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  • Registered Nurse RN Case Mgr…

    HCA Healthcare (West Palm Beach, FL)
    …compelling, we encourage you to apply for our Registered Nurse RN Case Mgr PRN opening. We promptly review all applications. Highly qualified candidates ... individual is recognized. Submit your application for the opportunity below: Registered Nurse RN Case Mgr...critical care experience + Certification in case management or utilization review preferred + InterQual experience preferred… more
    HCA Healthcare (09/12/25)
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  • Registered Nurse RN case Mgr

    HCA Healthcare (Margate, FL)
    …growth, we encourage you to apply for our Registered Nurse RN case Mgr opening. We promptly review all applications. Highly qualified candidates will ... **Introduction** Do you have the career opportunities as a(an) Registered Nurse RN case Mgr...critical care experience + Certification in case management or utilization review preferred + InterQual experience preferred… more
    HCA Healthcare (08/15/25)
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  • Registered Nurse Case Mgr RN

    HCA Healthcare (Aventura, FL)
    …HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a(an) Registered Nurse Case Mgr RN PRN with HCA Florida Aventura ... in our organization. We are looking for an enthusiastic Registered Nurse Case Mgr RN ...critical care experience + Certification in case management or utilization review preferred + InterQual experience preferred… more
    HCA Healthcare (08/09/25)
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