- Veterans Affairs, Veterans Health Administration (Winter Park, FL)
- Summary The Orlando VA Medical Center is seeking a Utilization Review Registered Nurse to join the Orlando VAMC team. The Utilization Review ... quality improvement and outcomes utilization consultation. Responsibilities The Utilization Review Registered Nurse leads the integration of… more
- MyFlorida (Orlando, FL)
- SENIOR REGISTERED NURSE SUPV Date: Nov 18, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... Requisition No: 863569 Agency: Veterans Affairs Working Title: SENIOR REGISTERED NURSE SUPV Pay Plan: Career Service...that the residents are receiving total nursing care. + Review shift assignments and ensure that the assignments reflect… more
- MyFlorida (Orlando, FL)
- REGISTERED NURSE Date: Nov 2, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 860343 Agency: Veterans Affairs Working Title: REGISTERED NURSE Pay Plan: Career Service Position...and procedures. + Monitor physician's orders for completion. + Review and follow-up on resident incidents or complaints. +… more
- AdventHealth (Winter Park, FL)
- …Degree Nursing + Current valid State of Florida or multistate license as a Registered Nurse + 2 years of medical/ hospital nursing experience **Preferred ... physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge...(as permitted by the patient) as well as a review of the current and past inpatient and outpatient… more
- AdventHealth (Orlando, FL)
- …of Nursing [Required] + 2 medical/hospital nursing experience [Required] + Registered Nurse (RN) [Required] **Preferred qualifications:** + Prior Care ... physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge...(as permitted by the patient) as well as a review of the current and past inpatient and outpatient… more
- AdventHealth (Winter Park, FL)
- …Care Management/ Utilization Management experience [Preferred] **Licenses and Certifications:** Registered Nurse (RN) [Required] Certified Case Manager (CCM) ... you'll bring to the team:** Actively participates in multi-disciplinary rounds to review changes in patient status, progression and level of care, and discharge… more
- Molina Healthcare (Orlando, FL)
- …managed care experience in the specific programs supported by the plan such as utilization review , medical claims review , long-term services and supports ... health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in… more
- AdventHealth (Orange City, FL)
- …succeed:** **Minimum qualifications** : + Associate's degree Nursing or RN Diploma degree. + Registered Nurse (RN) State specific license. + Two (2) years of ... physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge...(as permitted by the patient) as well as a review of the current and past inpatient and outpatient… more
- Molina Healthcare (Orlando, FL)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... unit (ICU) or emergency room. Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG… more
- Molina Healthcare (Orlando, FL)
- For this position we are seeking a (RN) Registered Nurse who must be licensed for the state they reside This role will be doing Utilization review for ... authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in… more
- Molina Healthcare (Orlando, FL)
- …internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more
- Molina Healthcare (Orlando, FL)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support for clinical member services...member care. The candidate must have Medicare Appeals and/or Utilization Management knowledge. Work hours are Monday-Friday 8:00am- 5:00pm… more
- Molina Healthcare (Orlando, FL)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... JOB DESCRIPTION **Job Summary** The Care Review Clinician (RN) provides support for clinical member...to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. **Required Qualifications** *… more
- Molina Healthcare (Orlando, FL)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary… more
- AdventHealth (Altamonte Springs, FL)
- …AND EXPERIENCE REQUIRED:** + Bachelor's of Nursing + 5 years of experience as a registered nurse in an acute care setting + Understanding of healthcare supply ... programs and processes within healthcare **LICENSURE, CERTIFICATION, OR REGISTRATION REQUIRED:** + Registered Nurse (RN) This facility is an equal opportunity… more
- CenterWell (Deland, 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
- AdventHealth (Orlando, FL)
- …**The role you'll contribute:** The Mission Control RN Tier 1 is a professional registered nurse functioning withing Mission Control in one of three primary ... verification process. Obtains pre-authorization and provides information to the Utilization Review Specialist, Utilization ...State of Florida or multi state license as a Registered Nurse . Graduate of school of Nursing… more
- Veterans Affairs, Veterans Health Administration (Winter Park, FL)
- …as customer service programs. Responsibilities The Community Care (CC) Community Health Registered Nurse (RN) is responsible for executing a streamlined approach ... intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- HCA Healthcare (Oviedo, FL)
- …to charitable organizations. Apply Today! **Job Summary and Qualifications** The Registered Nurse (RN)CM is responsible for promoting patient-centered care ... supporting a balance of optimal care and appropriate resource utilization . + Provides case management services for both inpatient...Value Statement." **What qualifications you will need:** + (RN) Registered Nurse + Registered … more