• Utilization Management Nurse

    Actalent (Sunrise, FL)
    Actalent is hiring a Utilization Management Nurse ! Job Description The Utilization Management Nurse (UMN) collaborates closely with the ... activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management ...between 2-4 weeks, with opportunities to shadow team members onsite and through Teams. Pay and Benefits The pay… more
    Actalent (07/18/25)
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  • Acute Care Case Manager , Registered Nurse…

    ChenMed (North Miami Beach, FL)
    …years' clinical work experience required. + A minimum of 1 year of utilization review and/or case management , home health, hospital discharge planning experience ... expanding and we need great people to join our team. The Acute Care Nurse (RN) is responsible for achieving positive patient outcomes and managing quality of care… more
    ChenMed (05/28/25)
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  • Utilization Management…

    Elevance Health (Miami, FL)
    ** Utilization Management Representative II** **Location:** This role enables associates to work virtually full-time in **Florida** , with the exception of ... 6 am - 6 pm EST including weekends. The ** Utilization Management Representative II** is responsible for...given. + Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care. +… more
    Elevance Health (07/10/25)
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  • Supervisor, Intensive Community Care - Registered…

    ChenMed (Winter Park, FL)
    …required if available in state. + A minimum of 2 years' onsite case management at ChenMed and/or utilization review or discharge planning in a hospital at ... to deliver on managing their case load by providing onsite and remote planning, clinical group leadership and expert...serve as coach, mentor/trainer to all members of care management team, giving guidance in best practices, troubleshooting to… more
    ChenMed (06/27/25)
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  • Nurse Reviewer I

    Elevance Health (Tampa, FL)
    …in an ambulatory or hospital setting or minimum of 1 year of prior utilization management , medical management and/or quality management , and/or ... and experiences:** + Behavioral health background preferred + Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding, and managed… more
    Elevance Health (07/16/25)
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  • Telephonic Nurse Case Manager II

    Elevance Health (Miami, FL)
    …required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care ... **Telephonic Nurse Case Manager II** **Location: This role enables...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
    Elevance Health (07/18/25)
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  • Nurse Case Manager II

    Elevance Health (Tampa, FL)
    …11:30AM-8:00PM EST The ** Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care needs ... **Title** : Nurse Case Manager II **Location** : 740W Peachtree...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
    Elevance Health (07/15/25)
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  • Nurse Case Mgr II (US)

    Elevance Health (Tampa, FL)
    …required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care ... **Telephonic Nurse Case Manager II** **Location:** This role requires...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
    Elevance Health (07/12/25)
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  • Triage Nurse I - Carebridge - Bilingual

    Elevance Health (FL)
    …nursing preferred. + Participation and/or certification in a managed care or utilization management organization preferred. + Ability to understand clinical ... and quality of life through home-care and community based services The **Triage Nurse I - Carebridge - Bilingual** is responsible for determining the appropriate… more
    Elevance Health (07/11/25)
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  • Client Service Manager, Government

    GetWellNetwork, Inc. (Tampa, FL)
    …Manager will take the Get Well program to the next level by driving nurse engagement, focusing on increased utilization , and leading projects of functionality to ... Manager Location & Travel: This position will be based onsite at the Tampa, FL VA hospital location Opportunity:...Well's Client Success Manager is responsible for effective product utilization and successful outcomes for the Get Well system… more
    GetWellNetwork, Inc. (06/29/25)
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