• Utilization Management

    Wellpath (Fort Lauderdale, FL)
    …for training, education, and point of care support. **How you make a difference** The Utilization Management Registered Nurse works under the guidance of ... more
    Wellpath (01/28/25)
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  • Senior Registered Nurse Supv - 1

    MyFlorida (Pembroke Pines, FL)
    SENIOR REGISTERED NURSE SUPV - 50000209 1 Date: Feb 12, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... more
    MyFlorida (02/12/25)
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  • Registered Nurse , CareLine Part…

    ChenMed (Miami, FL)
    …We're rapidly expanding and we need great people to join our team. The Registered Nurse , CareLine, PRN is responsible for providing telephonic triage directional ... more
    ChenMed (02/12/25)
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  • Advanced Practice Registered Nurse

    University of Miami (Miami, FL)
    …this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Advanced Practice Registered Nurse Pediatrics, Child Protection ... more
    University of Miami (02/04/25)
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  • Registered Nurse , Virtual Care…

    ChenMed (Miami, FL)
    …We're rapidly expanding and we need great people to join our team. The Registered Nurse , Virtual Care is responsible for providing telephonic triage directional ... more
    ChenMed (02/14/25)
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  • Case Manager Registered Nurse - Full…

    University of Miami (Miami, FL)
    …of Case Management . + Incorporates the fundamental principles of utilization management , monitoring resource consumption, social services intervention and ... more
    University of Miami (02/12/25)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Fort Lauderdale, FL)
    …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... more
    Fresenius Medical Center (02/14/25)
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  • Field Family Nurse Practitioner (Boise/Twin…

    Molina Healthcare (Miami, FL)
    …driver's license **PREFERRED EDUCATION:** **PREFERRED EXPERIENCE:** + 3-5-year experience as a Registered Nurse and/or Nurse Practitioner, ideally in a ... more
    Molina Healthcare (12/08/24)
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  • Clinical Appeals Nurse (RN): Texas and New…

    Molina Healthcare (Miami, FL)
    …Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + ... more
    Molina Healthcare (02/09/25)
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  • RN Nurse Manager Operating Room

    HCA Healthcare (Tamarac, FL)
    …of care. **What qualifications you will need:** + Current Florida license as Registered Nurse or Recognized Compact Licensure (subject to Florida State Licensing ... more
    HCA Healthcare (12/03/24)
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  • RN Nurse Manager Womens Services

    HCA Healthcare (Margate, FL)
    …of care. **What qualifications you will need:** + Current Florida license as Registered Nurse or Recognized Compact Licensure (subject to Florida State Licensing ... more
    HCA Healthcare (01/30/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Miami, FL)
    …of payment decisions. + Serves as a clinical resource for Utilization Management , Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. ... more
    Molina Healthcare (01/25/25)
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  • Registered Cardio Invasive Tech, Pool…

    Surgery Care Affiliates (Fort Lauderdale, FL)
    …and differentiated ways as part of Optum and with our new Specialty Management Solutions business. + We have pioneered a physician-led, multi-site model of practice ... more
    Surgery Care Affiliates (01/19/25)
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  • Assoc. VP, Care Coordination

    University of Miami (Miami, FL)
    …Care Coordination provides strategic leadership and oversight of care coordination, case management , social services, and utilization management across all ... more
    University of Miami (12/08/24)
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  • Manager, Healthcare Services (Remote)

    Molina Healthcare (Miami, FL)
    …site of service. **This position is seeking someone with experience in utilization management . Please include your experience on your resume.** ... more
    Molina Healthcare (02/09/25)
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  • Manager, HCS Clinical Policy - Medicare (Remote)

    Molina Healthcare (Miami, FL)
    …integrated) performing one or more of the following activities: utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.). ... more
    Molina Healthcare (02/14/25)
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  • Director of Quality Management - Inpatient…

    Select Medical (Miami, FL)
    …of acute transfers and other CQI indicators. **Qualifications** **Minimum Qualifications** + Registered Nurse with valid state license. Legacy employees may ... more
    Select Medical (02/14/25)
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  • Program Manager, HCS (Remote)

    Molina Healthcare (Miami, FL)
    …materials and other related documentations. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational ... more
    Molina Healthcare (02/16/25)
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  • UM Clinical Reviewer

    Centers Plan for Healthy Living (Margate, FL)
    …Healthy Living is currently accepting applications for Full Time Registered Nurse without experience. The Utilization Management Clinical Reviewer works ... more
    Centers Plan for Healthy Living (12/03/24)
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  • COE CM Director, (RN required)

    Molina Healthcare (Miami, FL)
    …State Registered Nursing (RN) license in good standing. + Utilization Management Certification (CPHM) Certified Professional in Health Care Quality ... more
    Molina Healthcare (01/21/25)
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