• RN Clinical Appeals

    Molina Healthcare (Miami, FL)
    JOB DESCRIPTION **Job Summary** The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals ... health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted… more
    Molina Healthcare (01/02/26)
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  • Clinical Appeals Nurse

    BayCare Health System (Clearwater, FL)
    …Qualifications:** + 2 years of experience with case management and/or clinical appeals or claims. + Registered Nurse **Facility:** BayCare Health System, ... team member be working remotely?** Hybrid Equal Opportunity Employer Veterans/Disabled **Position** Clinical Appeals Nurse - Health Plan **Location**… more
    BayCare Health System (12/19/25)
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  • Clinical Registered Nurse

    Cognizant (Tallahassee, FL)
    …to be considered** + Educational background - Registered Nurse ( RN ) + 2-3 years combined clinical and/or utilization management experience with managed ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...clinic operations + Experience in utilization management to include Clinical Appeals and Grievances, precertification, initial and… more
    Cognizant (12/23/25)
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  • Nurse Appeals - Litigation & Legal…

    Elevance Health (FL)
    ** Nurse Appeals - Litigation & Legal...Review requests. + Acts as a resource for both clinical and non- clinical teams, by managing and ... necessary and is dependent on court hearing schedules. The ** Nurse Appeals - Litigation & Legal Support**...would provide an equivalent background. + Current active unrestricted RN license to practice as a health professional within… more
    Elevance Health (12/22/25)
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  • Appeals Nurse

    Evolent (Tallahassee, FL)
    …to Standard processing, documenting accordingly. + Works closely with the appeals -dedicated Clinical Reviewers to ensure timely adjudication of processed ... for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a...and Preferred:** + 1-3 years' experience and as an RN - **Required** + Minimum of 5 years in… more
    Evolent (12/24/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (Orlando, FL)
    For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... (Team will work on set schedule) Looking for a RN with experience with appeals , claims review,...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/23/25)
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