• Supervisor, Behavioral Health Utilization

    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 ... hiring!** **We're looking for two remote Supervisors of Behavioral Health Utilization Management to support our Florida market. In this leadership role, you'll… more
    Centene Corporation (05/15/25)
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  • Utilization Management Nurse

    CVS Health (Tallahassee, FL)
    …anywhere in the state of Florida. **Applicant must reside in Florida** . As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and...setting required - Must have active current and unrestricted RN licensure in state of Florida - Willingness to… more
    CVS Health (05/16/25)
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  • Utilization Management

    Wellpath (Fort Lauderdale, FL)
    …for training, education, and point of care support. **How you make a difference** The Utilization Management Registered Nurse works under the guidance of ... accordance with applicable state and local laws. Quick Apply (https://careers-wellpath.icims.com/jobs/177156/ utilization - management - registered - nurse /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336175207) **Need help… more
    Wellpath (05/14/25)
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  • Utilization Management RN

    AdventHealth (Altamonte Springs, FL)
    …role you will contribute:** The role of the Utilization Management (UM) Registered Nurse ( RN ) is to use clinical expertise by analyzing patient ... including concurrent payer communications to resolve status disputes. The Utilization Management Nurse is accountable.... Current and valid license to practice as a Registered Nurse (ADN or BSN) required. .… more
    AdventHealth (05/14/25)
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  • Utilization Management Nurse

    CVS Health (Tallahassee, FL)
    …active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include weekends, ... **Required Qualifications** + 2+ years of experience as a Registered Nurse in adult acute care/critical care...or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing… more
    CVS Health (05/16/25)
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  • RN Utilization Management

    Humana (Tallahassee, FL)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...a resume with your application. **Required Qualifications** + Active Registered Nurse ( RN ) license in… more
    Humana (05/16/25)
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  • Utilization Management Behavioral…

    Humana (Tallahassee, FL)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in an… more
    Humana (05/13/25)
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  • Senior Accreditation Utilization

    Humana (Tallahassee, FL)
    …+ Minimum 3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management + Exceptional attention to detail. + Demonstrated excellent time ... + Expertise on NCQA accreditation standards, especially related to Utilization Management and/or Behavioral Health; MED-Deeming accreditation standards… more
    Humana (05/09/25)
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  • Registered Nurse RN Care…

    AdventHealth (Orlando, FL)
    …documents avoidable days, and facilitates progression of care. Collaborates with Utilization Management staff for collaboration on patient status changes ... valid State of Florida or multistate license as a Registered Nurse + 2 years of medical/...+ Health-related master's degree or MSN + Prior Care Management / Utilization Management experience +… more
    AdventHealth (05/12/25)
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  • RN Case Manager - Case Management

    Mayo Clinic (Jacksonville, FL)
    …expenses. + Retirement: Competitive retirement package to secure your future. **Responsibilities** The Registered Nurse ( RN ) Case Manager works within an ... by ensuring appropriate utilization management , care coordination, resource utilization , and clinical documentation. The RN Case Manager will function… more
    Mayo Clinic (05/03/25)
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