• Utilization Review RN

    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 ... and Part-Time roles **Job Summary** The Utilization Review Nurse - RN reviews...patient-centered service and continuous improvement. **Licenses and Certifications** + RN - Registered Nurse -… more
    Community Health Systems (11/20/25)
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  • 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 (10/10/25)
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  • Utilization Review Team Lead

    BayCare Health System (St. Petersburg, FL)
    … Management or 6 years of clinical nursing **Certifications and Licensures:** + Required RN ( Registered Nurse ) + Preferred ACM (Case Management) + Preferred ... trust, dignity, respect, responsibility and clinical excellence. **The Team Lead Utilization Review responsibilities include:** + Directing and coordinating the… more
    BayCare Health System (11/12/25)
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  • Utilization Review Clinician…

    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 ... and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and… more
    Centene Corporation (12/05/25)
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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 (09/12/25)
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  • RN Medical Review Nurse

    Molina Healthcare (Tampa, FL)
    … and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must be active and unrestricted ... **Job Description** **Job Summary** The Medical Review Nurse provides support for medical...our Appeals and Grievances department. We are seeking a Registered Nurse with previous Appeals experience. The… more
    Molina Healthcare (12/03/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (Jacksonville, 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 (12/06/25)
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  • Registered Nurse RN case Mgr

    HCA Healthcare (Margate, FL)
    …growth, we encourage you to apply for our Registered Nurse RN case Mgr opening. We promptly review all applications. Highly qualified candidates will ... **Introduction** Do you have the career opportunities as a(an) Registered Nurse RN case Mgr...critical care experience + Certification in case management or utilization review preferred + InterQual experience preferred… more
    HCA Healthcare (11/14/25)
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  • Registered Nurse RN Case Mgr

    HCA Healthcare (Atlantis, FL)
    …**Introduction** Do you want to join an organization that invests in you as a(an) registered Nurse RN Case Mgr? At HCA Florida JFK Hospital, you ... make a difference. We are looking for a dedicated registered Nurse RN Case Mgr...critical care experience + Certification in case management or utilization review preferred + InterQual experience preferred… more
    HCA Healthcare (11/19/25)
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  • Registered Nurse Case Mgr RN

    HCA Healthcare (Aventura, FL)
    …HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a(an) Registered Nurse Case Mgr RN PRN with HCA Florida Aventura ... in our organization. We are looking for an enthusiastic Registered Nurse Case Mgr RN ...critical care experience + Certification in case management or utilization review preferred + InterQual experience preferred… more
    HCA Healthcare (11/08/25)
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  • Registered Nurse RN Case Mgr…

    HCA Healthcare (Tamarac, FL)
    …**Introduction** Do you want to join an organization that invests in you as a(an) Registered Nurse RN Case Mgr PRN? At HCA Florida Woodmont Hospital, ... make a difference. We are looking for a dedicated Registered Nurse RN Case Mgr...of critical care experience Certification in case management or utilization review preferred + InterQual experience preferred… more
    HCA Healthcare (10/24/25)
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  • Registered Nurse , Nursing Officer…

    Veterans Affairs, Veterans Health Administration (Tampa, FL)
    Summary James A Haley is excited to recruit a Registered Nurse , Nursing Officer of the Day (NOD) . This registered nurse would be responsible and ... Administrative Officer (AOD), Transfer Coordinator, the Emergency Room, Admissions, Utilization Review , and Acute Care charge nurses...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
    Veterans Affairs, Veterans Health Administration (12/09/25)
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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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  • 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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  • RN Case Manager

    HCA Healthcare (Tallahassee, FL)
    …FL RN license required within 90 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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  • Oncology Prior Authorization Case Manager, Non-…

    University of Miami (Miami, FL)
    …of UMHC SCCC Business Operations has an exciting opportunity for a full time Utilization Review Case Manager to work to work remote. The incumbent conducts ... initial, concurrent and retrospective chart reviews for clinical utilization and authorization. The Utilization Review...reviews for clinical utilization and authorization. The Utilization Review Case Manager coordinates with the… more
    University of Miami (11/25/25)
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  • RN Clinical Manager, Home Health

    CenterWell (The Villages, FL)
    review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
    CenterWell (11/27/25)
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  • RN Clinical Manager, Home Health

    CenterWell (Ocala, FL)
    review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
    CenterWell (11/20/25)
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  • RN Case Manager

    HCA Healthcare (Sanford, FL)
    …is preferred + BSN is preferred + Certification in Case Management, Nursing or Utilization Review is preferred HCA Florida Lake Monroe Hospital is a 221-bed ... supporting a balance of optimal care and appropriate resource utilization . You would be part of a phenomenal team...opportunity compelling, we encourage you to apply for our RN Case Manager opening. We promptly review more
    HCA Healthcare (11/10/25)
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  • Director of Case Management ( RN / RT / MSW…

    Select Medical (Gainesville, FL)
    …of Case Management** **Full Time: Monday - Friday 8-5pm** **_Clinical license as a registered nurse or respiratory therapist or master's in social work and ... and professional growth of the department, including, but not limited to: Utilization Review (UR) and resource management, discharge planning, treatment plan… more
    Select Medical (12/09/25)
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