• 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 (05/03/25)
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  • Registered Nurse , CareLine…

    ChenMed (Miami, FL)
    …We're rapidly expanding and we need great people to join our team. The Registered Nurse 1, Care Line, is responsible for providing telephonic triage directional ... and assessments within license and as possible given technology and medium. The registered nurse collaborates with primary caregivers and others on the… more
    ChenMed (05/04/25)
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  • Registered Nurse , Telehealth, Part…

    ChenMed (Miami, FL)
    …rapidly expanding and we need great people to join our team. The Registered Nurse , Virtual Care, CareLine, is responsible for providing telephonic emergency ... client counseling, patient advocacy, health education and referral and resource management to ChenMed patients and their families. Providing on-call coverage, the… more
    ChenMed (04/30/25)
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  • Registered Nurse , Telehealth…

    ChenMed (Miami, FL)
    …rapidly expanding and we need great people to join our team. The Registered Nurse , Telehealth is responsible for providing telephonic triage directional patient ... issues, client counseling, patient advocacy, health education and referral and resource management to ChenMed patients and their families. The incumbent in this role… more
    ChenMed (04/24/25)
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  • Pre-Authorization Registered Nurse

    Humana (Tallahassee, FL)
    …professional onsite, field, or remote based opportunities. The Prior Authorization, Registered Nurse , RN , Intern will utilize Humana's Medicaid training ... the goal to put health first? The Prior Authorization, Registered Nurse , RN , Intern will...experience a plus. + Previous experience in prior authorization, utilization management + Experience working with MCG… more
    Humana (04/30/25)
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  • Case Manager, registered Nurse…

    CVS Health (Tallahassee, FL)
    …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... reviews **Required Qualifications** - 5+ years' experience as a Registered Nurse with at least 1 year...using a keyboard **Preferred Qualifications** - 1+ years' Case Management experience or discharge planning, nurse navigator… more
    CVS Health (04/30/25)
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  • Senior Compliance Registered Nurse

    Humana (Tallahassee, FL)
    …of our caring community and help us put health first** The Senior Compliance Nurse reviews utilization management activities and documentation to ensure ... your skills to make an impact** **Required Qualifications:** + Registered Nurse with a Bachelor's degree in...action + Minimum two, (2) years of experience in utilization management + Intermediate proficiency using Microsoft… more
    Humana (05/06/25)
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  • SNF Utilization Management RN

    Humana (Tallahassee, FL)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse utilizes clinical nursing skills to support the ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse work assignments are varied… more
    Humana (05/03/25)
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  • Denials Management RN Specialist…

    AdventHealth (Altamonte Springs, FL)
    …expertise and experiences you'll need to succeed:** . Bachelor's . 1 Related Experience . Registered Nurse ( RN ) . Extensive understanding of CPT, HCPCS, ICD, ... rebilling. + Collaborates with pre-access, patient financial services, revenue integrity, utilization management and clinical department staff to obtain further… more
    AdventHealth (05/06/25)
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  • Utilization Management Nurse…

    CVS Health (Tallahassee, FL)
    …Qualifications** + Must reside in EST zone + 3+ years of experience as a Registered Nurse + 3+ years of clinical experience required + Must have active ... reside in EST time zone.** This is a full-time remote position. + Utilizes clinical experience and skills in...able to work Monday through Friday, 8:00am to 5:00pm. Utilization management is a 24/7 operation. Work… more
    CVS Health (05/02/25)
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