• Registered Nurse Utilization

    AdventHealth (Tampa, FL)
    …Stroke Center. **The role** **you'll** **contribute:** The role of the Utilization Management (UM) Registered Nurse (RN) is to use clinical expertise ... align with the physician order or a status conflict is indicated, the UM nurse is responsible for escalation to the Physician Advisor or designated leader for… more
    AdventHealth (05/12/25)
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  • Registered Nurse

    MyFlorida (Land O' Lakes, FL)
    REGISTERED NURSE - 50000059 Date: Apr 25, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 843800 Agency: Veterans Affairs Working Title: REGISTERED NURSE - 50000059 Pay Plan: Career Service… more
    MyFlorida (04/02/25)
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  • Registered Nurse RN Home Health

    AdventHealth (Tarpon Springs, FL)
    ** Registered Nurse Case Manager -** **AdventHealth Home Health** **All the benefits and perks you need for you and your family:** + Up to $10,000 Sign on Bonus + ... County area. **The role you'll contribute:** The Home Health Registered Nurse (RN) Care Manager is a...needs. The RN Care Manager is responsible for independent management of the Home Health patient population requiring the… more
    AdventHealth (05/12/25)
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  • RN Manager Healthcare Services…

    Molina Healthcare (St. Petersburg, FL)
    **JOB DESCRIPTION** For this position we are seeking a (RN) Registered Nurse who be licensed in the state they reside. We are looking for a RN Manager to manage ... a utilization management team supporting 14 Marketplace plans....identifying opportunities for improvement. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed… more
    Molina Healthcare (05/10/25)
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  • RN Registered Nurse Care Manager PRN

    AdventHealth (Tampa, FL)
    …patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the interdisciplinary team ... core competencies of this role. The RN Care Manager facilitates the collaborative management of patient care across the continuum, intervening to remove barriers to… more
    AdventHealth (05/10/25)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Trinity, FL)
    …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... + Preferred but not required: + 3+ years supervisory or project/program management experience. + Med/surg or ICU/CCU experience. **PHYSICAL DEMANDS AND WORKING… more
    Fresenius Medical Center (04/25/25)
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  • Care Review Clinician, Prior Authorization…

    Molina Healthcare (St. Petersburg, FL)
    …**JOB QUALIFICATIONS** **Required Education** Any of the following: Completion of an accredited Registered Nurse (RN), Licensed Vocational Nurse (LVN) or ... in good standing Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual /… more
    Molina Healthcare (04/05/25)
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  • Delegation Oversight Nurse Remote based…

    Molina Healthcare (St. Petersburg, FL)
    Nurse in good standing. **Preferred Education** Completion of an accredited Registered Nurse (RN) Program or a bachelor's degree in Nursing. **Preferred ... contained in the delegation agreement. **KNOWLEDGE/SKILLS/ABILITIES** The Delegation Oversight Nurse is responsible for ensuring that Molina Healthcare's UM… more
    Molina Healthcare (04/11/25)
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  • Clinical Appeals Nurse (RN)

    Molina Healthcare (St. Petersburg, FL)
    …Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + ... as may be required. + Serves as a clinical resource for Utilization Management , Chief Medical Officer, Physicians, and Member/Provider Inquiries/Appeals. +… more
    Molina Healthcare (05/10/25)
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  • Nurse Manager- Operating Room- St. Joseph…

    BayCare Health System (Tampa, FL)
    …is highly preferred. **Certifications, Licensures, Education:** + BLS - Required + Registered nurse license- Required. + Bachelor's degree in nursing- Required ... amazing team and a great place to work!** The ** Nurse Manager** a leader within the health system who...when in the clinical setting + Responsible for appropriate utilization of team resources to effectively and efficiently provide… more
    BayCare Health System (05/10/25)
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  • Director Case Management

    HCA Healthcare (Hudson, FL)
    …actively engaging interdisciplinary teams and external stakeholders. The Director is a registered nurse with responsibility for all operational aspects of the ... degree in Nursing, Health Administration, or Business Administration, preferred + Either Registered Nurse (RN) licensure , Licensed Clinical Social Worker (LCSW)… more
    HCA Healthcare (04/10/25)
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  • Interim Director of Case Management

    HealthTrust Workforce Solutions (Brandon, FL)
    …access to more than 200,000 jobs nationwide. **_JOB SUMMARY_** The Interim Leader of Case Management Services is a Registered Nurse who participates as an ... budget and resource management , cost control, contract compliance, quality improvement, utilization management , denials management and management of… more
    HealthTrust Workforce Solutions (04/16/25)
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  • Clinical Manager Home Health FT

    CenterWell (Clearwater, FL)
    …license, auto insurance and reliable transportation. + Two years as a Registered Nurse with at least one-year of management experience in a home care, ... clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
    CenterWell (05/09/25)
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  • Case Mgr RN/26/Nur023

    Adecco US, Inc. (Tampa, FL)
    …partnered with a reputable Healthcare client to find a dedicated and experienced ** Registered Nurse , Case Manager** in Tampa, FL. **Job Title:** **Acute ... Transitional Care Nurse (RN) - Telecommuter** **Department:** Comprehensive Clinical ...hospital setting. **Preferred Qualifications:** + Experience in care continuum management , utilization review, or discharge planning. +… more
    Adecco US, Inc. (04/15/25)
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  • RN Program Manager Healthcare Services

    Molina Healthcare (St. Petersburg, FL)
    **JOB DESCRIPTION** For this position we are seeking a (RN) Registered Nurse who must be licensed for the state they reside. Program Manager RN will be ... and other related documentations. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed...years in one or more of the following areas: utilization management , case management , care… more
    Molina Healthcare (05/10/25)
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  • Home Care Supervisor, RN

    BayCare Health System (Dunedin, FL)
    …part of an amazing team and a great place to work!** **Requirements:** + RN ( Registered Nurse ) License + Driver's License, State of Florida required within 30 ... takes a special kind of person to become a nurse . And we're hoping that you're one of those...area of responsibility. + Ensure quality assurance program and utilization review is followed in accordance with Home Care… more
    BayCare Health System (04/16/25)
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  • Care Review Clinician, PA (RN) - Transplant Team…

    Molina Healthcare (St. Petersburg, FL)
    …internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital ... requests for transplants; the ideal candidate will have experience either in utilization review or case management for transplants. Preference will be… more
    Molina Healthcare (03/07/25)
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  • Dementia Care Navigator, Social Worker

    Bluestone Physician Services (Tampa, FL)
    …with primary care teams to ensure high quality team-based care + Use utilization management tools to facilitate appropriate transitional care management ... + Degree in Social Work, Licensed Social Worker or Registered Nurse + 3-5 years of experience...Nurse + 3-5 years of experience in case/care management or care coordination + Experience working directly with… more
    Bluestone Physician Services (05/11/25)
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  • Program Administrator - SES

    MyFlorida (Largo, FL)
    …leave. Paid holidays and personal day. Retirement package. REQUIREMENTS + Unencumbered Florida Registered Nurse License. + Must be willing and able to travel ... (4) or more years of experience as a Licensed Registered Nurse in Long-Term Care facility, or...Long-Term Care. POSITION DESCRIPTION Overview: The direct leadership and management of clinical processes and systems to assure positive… more
    MyFlorida (04/05/25)
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  • RN Coordinator OR Service Line

    HCA Healthcare (St. Petersburg, FL)
    …**What qualifications you will need:** We are seeking an experienced and professional Registered Nurse to become our Coordinator of OR Service Line. You ... clinical excellence behind the scenes in data science, case management or transfer centers. Unlock your potential at HCA...workflow. **Qualifications** + Must be licensed as a Florida Registered Nurse in accordance with state regulations… more
    HCA Healthcare (03/20/25)
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