• 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 (01/09/26)
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  • Utilization Review Nurse

    Actalent (Tampa, FL)
    …complete cases. Qualifications: + 3+ years of utilization management, concurrent review , prior authorization, utilization review , case management, and ... Urgent Hiring for "Remote Clinical Review Nurses" Job Description: + Review ...discharge planning is must + Active RN Compact License is Must If you are Interested… more
    Actalent (01/10/26)
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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 (12/12/25)
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  • Medical Review Nurse ( RN

    Molina Healthcare (Miami, FL)
    … and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must be active and unrestricted ... 2 years clinical nursing experience, including at least 1 year of utilization review , medical claims review , long-term services and supports (LTSS), claims… more
    Molina Healthcare (01/09/26)
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  • Care Review Clinician ( RN )

    Molina Healthcare (FL)
    …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... unit (ICU) or emergency room. Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG… more
    Molina Healthcare (01/09/26)
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  • Case Manager, Registered Nurse

    CVS Health (Tallahassee, FL)
    …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
    CVS Health (01/03/26)
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  • RN Case Manager

    Adecco US, Inc. (Tallahassee, FL)
    …basis **Position Overview** A large acute care hospital is seeking an experienced ** Registered Nurse Case Manager** to join its Case Management team. This ... **Position Title:** Case Manager RN **Location:** Tallahassee, FL 32310 **Position Type:** Nursing...if current and compliant + Case Management, Nursing, or Utilization Review certification preferred **Benefits** + Comprehensive… more
    Adecco US, Inc. (12/18/25)
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  • RN Case Manager Part Time

    HCA Healthcare (Tallahassee, FL)
    …active FL RN license required within90 days of hire** + **Advanced Practice Registered Nurse license is acceptable for position if current and compliant** + ... supporting a balance of optimal care and appropriate resource utilization . The RN CM Care Coordinator will...**Certification in Case Management, Nursing, or Utilization Review , preferred** + **Three years of… more
    HCA Healthcare (11/10/25)
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  • Manager of Care Management - RN

    Community Health Systems (Naples, FL)
    …platforms, healthcare software systems, and data analysis tools. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact ... for the planning, coordination, and oversight of care management services, including utilization review , discharge planning, and transitions of care. The role… more
    Community Health Systems (11/22/25)
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  • RN Case Manager Evenings

    HCA Healthcare (Tallahassee, FL)
    …active FL RN licenserequiredwithin90 days of hire** + **Advanced Practice Registered Nurse license is acceptable for position if current and compliant** ... supporting a balance of optimal care and appropriate resource utilization . The RN CM Care Coordinator will...+ **Certification in Case Management, Nursing, or Utilization Review , preferred** + **Three years of… more
    HCA Healthcare (11/10/25)
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