- Battelle Memorial Institute (Tampa, FL)
- …two years' nursing experience + Current, full, active, and unrestricted license as a Registered Nurse in any US State, the District of Columbia, Guam, Puerto ... (HRA) business line is seeking a highly motivated, full-time ** Nurse Case Manager** to join our team in support...professional parameters + Knowledge and skill in using pre-established utilization review criteria to recognize and report… more
- 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
- AdventHealth (Tampa, FL)
- …and other diseases. **The role you'll contribute:** The Utilization Management nurse uses clinical expertise to review patient records in the emergency ... providers in emergency department setting. Utilize critical thinking and expertise in utilization review regarding medical necessity, patient status, level of… more
- Molina Healthcare (Tampa, 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 (Tampa, FL)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more
- CenterWell (Tampa, 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
- Molina Healthcare (Tampa, FL)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal...the specific programs supported by the plan such as utilization review , medical claims review ,… more
- BayCare Health System (Dunedin, FL)
- …with 1 year Home Health RN visit experience. **Required Credentials:** + RN ( Registered Nurse ) License + Diploma, Associate's or Bachelor's Nursing ... regulatory bodies within the area of responsibility + Ensure quality assurance program and utilization review is followed in accordance with Home Care protocol +… more
- MyFlorida (Land O' Lakes, FL)
- …that all verbal orders, including telephone orders from attending physicians are received by a registered nurse . If no RN is available, receive all telephone ... SENIOR REGISTERED NURSE SUPV - 50000070 Date:...current status and providing supervision and guidance to the RN , LPN, CNA and other Allied Health Care Professionals.… more
- AdventHealth (Tampa, FL)
- …**The expertise and experiences you'll need to succeed:** Associate's of Nursing Required Registered Nurse ( RN ) Required Basic Life Support - CPR ... Participates in conducting performance appraisals for personnel on assigned shift. The Registered Nurse provides self-directed, effective nursing care to groups… more
- HCA Healthcare (Trinity, FL)
- …charitable organizations. Apply Today! **Job Summary and Qualifications** We are seeking a Registered Nurse Case Manager. You will provide clinical expertise to ... promote cost effectiveness through the integration of case management, utilization review management and discharge planning. **What...we encourage you to apply for our Case Manager RN opening. We promptly review all applications.… more
- Deloitte (Tampa, FL)
- …Bachelor's degree in nursing, medical degree, or physician assistant required + Current Registered Nurse ( RN ) license required + Certified Clinical ... nurse , physician, physician assistant, case manager, clinical documentation specialist, utilization review , informatics RN , Quality, DRG Validation and… more
- HCA Healthcare (Trinity, FL)
- …related field required; Master's Degree preferred .Current Florida licensure as a Registered Nurse preferred _**If serving as facility's primary Risk Manager, ... Quality) OR CHCQM (Diplomate in American Board of Quality Assurance and Utilization Review Physicians) _Individuals without CPHQ or ABQUARP will be granted a 12… more
- Elevance Health (Tampa, FL)
- …or case management experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or any combination of education ... include every weekend (Saturday and Sunday). The **Medical Management Nurse ** will be responsible for review of...Capabilities, and Experiences:** + Current active, valid and unrestricted RN license and/or certification to practice as a health… more
- Molina Healthcare (Tampa, FL)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... (Team will work on set schedule) Looking for a RN with experience with appeals, claims review ,...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Tampa, FL)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support...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 (Tampa, FL)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary… more
- HCA Healthcare (Hudson, FL)
- …to learn! **Job Summary and Qualifications** We are seeking an experienced and professional Registered Nurse to become our Coordinator of OR Service Line. You ... colleagues in their positions. Join our Team as an RN Coordinator in the Operating Room and access programs...workflow. **Qualifications** + Must be licensed as a Florida Registered Nurse in accordance with state regulations… more
- MyFlorida (Land O' Lakes, FL)
- SENIOR LICENSED PRACTICAL NURSE - 50000083 Date: Nov 13, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... Requisition No: 865263 Agency: Veterans Affairs Working Title: SENIOR LICENSED PRACTICAL NURSE - 50000083 Pay Plan: Career Service Position Number: 50000083 Salary:… more
- Elevance Health (Tampa, FL)
- **Telephonic Nurse Case Manager II** **Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... the assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of… more
