- Lee Health (Fort Myers, FL)
- …to Midpoint Pay Rate: $38.48 - $50.01 / hour (Salary/Exempt) Previous Supervisory/ Management of Staff preferred Three (3) years of Home Health experience, Two ... distributions, and assists in meeting financial targets by effectively managing utilization , productivity, personnel and supplies. This position ensures adherence to… more
- Humana (Tallahassee, FL)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CVS Health (Tallahassee, FL)
- …we do it all with heart, each and every day. **Position Summary** The ** Utilization Management Clinical Nurse Consultant** utilizes clinical skills to ... Arizona Time Zone. **Preferred Qualifications** : + Previous experience with utilization management . + Previous clinical experience in Emergency Department,… more
- CVS Health (Tallahassee, FL)
- …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in ET zones **Education**… more
- CVS Health (Tallahassee, FL)
- …1+ years of clinical experience in acute or post-acute setting, and 1+ years of Utilization Management / Care Management Experience + Must have active ... additional Nursing Licenses as business needs require. **Preferred Qualifications** Utilization Management experience preferred **Education** Education: Diploma… more
- CVS Health (Tallahassee, FL)
- …years of clinical experience in acute or post-acute setting,and 1+ years of Utilization Management / CareManagementExperience + Must have active current and ... obtainadditionalNursing Licenses as business needsrequire. * **Preferred Qualifications** - Utilization Management experience preferred - **Anticipated Weekly… more
- CenterWell (Tallahassee, FL)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Community Health Systems (Naples, FL)
- Join us as a **Registered Nurse (RN) - Utilization Review position** at Physicians Regional Collier Unit: Utilization Review Shift: Mon-Fri (this is an ... 401k match & more available for Full and Part-Time roles **Job Summary** The Utilization Review Nurse - RN reviews hospital admissions, extended stays, and… more
- ERP International (Macdill AFB, FL)
- …is seeking a **Registered** ** Nurse (RN)** for a Full-Time position in ** Utilization Management ** at MacDill AFB, FL. Apply online today and discover more ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
- BayCare Health System (Tampa, FL)
- …Occasional + **On Call:** No **Certifications and Licensures:** + Required RN (Registered Nurse ) + Preferred ACM (Case Management ) + Preferred CCM (Case Manager) ... Required 2 years in Utilization Review or + Required 2 years in Case Management or + Required 3 years Registered Nurse + Preferred experience in Critical… more
- BayCare Health System (St. Petersburg, FL)
- …experience includes 3 years of Case Management or 3 years of Utilization Management or 6 years of clinical nursing **Certifications and Licensures:** + ... Required RN (Registered Nurse ) + Preferred ACM (Case Management ) +...Bachelors in Nursing **Experience:** + Required 3 years in Utilization Management or + Required 3 years… more
- Centene Corporation (Tallahassee, FL)
- …28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive ... Analyzes BH member data to improve quality and appropriate utilization of services + Provides education to providers members...Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required… more
- Elevance Health (Tampa, FL)
- **Medical Management Nurse ** **Location:** Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training ... **Must reside in the state of Florida** The **Medical Management Nurse ** will be responsible for review...experience and requires a minimum of 2 years clinical, utilization review, or managed care experience; or any combination… more
- HCA Healthcare (Kissimmee, FL)
- …**Introduction** Are you ready to manage in a new era as a Manager Case Management where building a healthier tomorrow is more than a job? Our HCA Florida Osceola ... happen at an HCA Healthcare facility. Be an impact as a(an) Manager Case Management where your passion for leading and creativity are valued? We want your knowledge… more
- MyFlorida (Chattahoochee, FL)
- REGISTERED NURSE SPECIALIST - F/C - 67072411 APD/ DDDP CHATTAHOOCHEE, FL Date: Dec 9, 2025 The State Personnel System is an E-Verify employer. For more information ... Agency: Agency for Persons with Disabilities Working Title: REGISTERED NURSE SPECIALIST - F/C - 67072411 APD/ DDDP CHATTAHOOCHEE,...dynamics. This position with APD will serve staff and management across the Agency. Your work will impact the… more
- MyFlorida (Macclenny, FL)
- REGISTERED NURSE SPECIALIST OPS - 60955263 Date: Nov 25, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 862161 Agency: Children and Families Working Title: REGISTERED NURSE SPECIALIST OPS - 60955263 Pay Plan: Health Care Practice Position Number:… more
- MyFlorida (Chattahoochee, FL)
- REGISTERED NURSE SUPERVISOR - 60005446 Date: Dec 4, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 858609 Agency: Children and Families Working Title: REGISTERED NURSE SUPERVISOR - 60005446 Pay Plan: Career Service Position Number: 60005446… more
- Evolent (Tallahassee, FL)
- …As a Clinical Reviewer, Nurse , you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... Clinical reviewers are supported by Field Medical Directors (MDs) in the utilization management determination process. + Reviews charts and analyzes clinical… more
- Veterans Affairs, Veterans Health Administration (Bay Pines, FL)
- Summary The Advanced Practice Nurse III Certified Nurse Practitioner (NP) practices in Geriatrics Service to provide a full range of services emphasizing ... Affairs (VA) mission. The NP provides advanced clinical practice, consultation, and management . Assigned under the Inpatient and Outpatient sections and reports the… more
