• 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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  • Medical Claim Review Nurse

    Molina Healthcare (Tampa, FL)
    …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... hours 6 AM to 6 PM (Team will work on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing… more
    Molina Healthcare (09/06/25)
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  • Care Review Clinician, PA ( RN )

    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
    Molina Healthcare (10/17/25)
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  • ED Utilization Management Registered

    AdventHealth (Tampa, FL)
    …you'll contribute:** The role of the Emergency Department Utilization Management (UM) Registered Nurse ( RN ) is to use clinical expertise by analyzing ... review as determined by department standards. The Utilization Management Nurse is accountable for a...electronic health records of at least two years Preferred RN - Registered Nurse -… more
    AdventHealth (10/11/25)
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  • RN Registered Nurse Care…

    AdventHealth (Tampa, FL)
    …Qualifications The expertise and experiences you'll need to succeed: .Associate Degree Nursing or RN Diploma degree. .Florida Registered Nurse ( RN ) ... well-balanced work life balance The role you'll contribute: The RN Care Manager in collaboration with the patient/family, social....Two (2 ) years of medical/hospital Registered Nurse experience This facility is an equal opportunity employer… more
    AdventHealth (09/27/25)
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  • RN Registered Nurse Care…

    AdventHealth (Tampa, FL)
    …- Nursing or RN Diploma degree Two (2 ) years of hospital Registered Nursing experience State specific RN license This facility is an equal opportunity ... heart failure, cancer and other diseases. **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses,… more
    AdventHealth (09/27/25)
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  • Home Care Supervisor, RN

    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
    BayCare Health System (10/10/25)
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  • RN Case Manager

    Adecco US, Inc. (Tampa, FL)
    …setting. **PREFERRED QUALIFICATIONS** : + Previous comprehensive care continuum management, utilization review or discharge planning experience. + HMO experience ... with our client in Florida to hire a Telecommute RN Case Manager for their facility. Candidates **MUST** reside...the cost consequences resulting from care delivery decisions through utilization of reports and systems such as Health Plan… more
    Adecco US, Inc. (10/03/25)
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  • RN - Care Management PRN

    AdventHealth (Land O' Lakes, FL)
    …for one another and respect for each persons unique contributions, provides utilization review care that is non-judgmental and non-discriminatory. Consider ... staff certifications include CCRN, PCCN, CNML, WCNC, NEA-BC, and RN -BC Onsite BSN completion program partnership with South University...(2) years of hospital nursing experience .Current license of registered nurse in Florida or licensure from… more
    AdventHealth (08/07/25)
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  • Registered Nurse Care Manager

    AdventHealth (Tampa, FL)
    …experiences you'll need to succeed:** Associate and 2 years experience Associates Degree Nursing or RN Diploma degree. Registered Nurse ( RN ). 2 years of ... support a well-balanced work life balance **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses,… more
    AdventHealth (10/02/25)
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  • Registered Nurse Care Manager…

    AdventHealth (Wesley Chapel, FL)
    …Qualifications **The expertise and experiences you'll need to succeed:** Associates Degree Nursing or RN Diploma degree. Registered Nurse ( RN ). State ... residents in west and central Pasco. **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses, physicians… more
    AdventHealth (10/07/25)
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  • Team Lead Registered Nurse PICU…

    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
    AdventHealth (10/02/25)
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  • RN - Care Manager

    AdventHealth (Zephyrhills, FL)
    …care. **The expertise and experiences you'll need to succeed:** Associates Degree Nursing or RN Diploma degree Registered Nurse ( RN ) Two (2) ... Care) Premium shopping outlets **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social...a hospital setting + One (1) year experience of utilization review This facility is an equal… more
    AdventHealth (10/17/25)
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  • Case Manager RN PRN

    HCA Healthcare (St. Petersburg, 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 PRN opening. We promptly review all… more
    HCA Healthcare (10/12/25)
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  • Case Manager RN

    HCA Healthcare (St. Petersburg, FL)
    …goals. Unlock your potential! **Job Summary and Qualifications** We are seeking a Registered Nurse Case Manager. You will provide clinical expertise to ensure ... You will promote cost effectiveness through the integration of case management, utilization review management and discharge planning. **What qualifications you… more
    HCA Healthcare (10/02/25)
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  • Case Manager RN

    HCA Healthcare (Brandon, FL)
    …be a part of our team. **Job Summary and Qualifications** We are seeking a Registered Nurse Case Manager. You will provide clinical expertise to ensure all ... organization that invests in you as a(an) Case Manager RN ? At HCA Florida Brandon Hospital, you come first....promote cost effectiveness through the integration of case management, utilization review management and discharge planning. **What… more
    HCA Healthcare (09/26/25)
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  • Case Manager RN

    HCA Healthcare (Largo, FL)
    …goals. Unlock your potential! **Job Summary and Qualifications** We are seeking a Registered Nurse Case Manager. You will provide clinical expertise to ensure ... hours volunteering in our communities. As a(an) Case Manager RN with HCA Florida Largo Hospital you can be...promote cost effectiveness through the integration of case management, utilization review management and discharge planning. **What… more
    HCA Healthcare (08/28/25)
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  • Case Manager RN

    HCA Healthcare (Hudson, FL)
    …goals. Unlock your potential! **Job Summary and Qualifications** We are seeking a Registered Nurse Case Manager. You will provide clinical expertise to ensure ... You will promote cost effectiveness through the integration of case management, utilization review management and discharge planning. **What qualifications you… more
    HCA Healthcare (09/11/25)
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  • Director of Quality

    HCA Healthcare (Largo, FL)
    …Healthcare Quality) OR CHCQM (Diploma in American Board of Quality Assurance and Utilization Review Physicians). _Individuals without CPHQ or_ CHCQM _will be ... our Director, you will provide direction to ensure the facilitation and utilization of diverse strategies and communication for quality and performance improvement… more
    HCA Healthcare (10/17/25)
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  • Medical Management Clinician Associate

    Elevance Health (Tampa, FL)
    …following standard procedures that do not require the training or skill of a registered nurse . **How You Will Make an Impact** Primary duties may include, ... a minimum of 2 years of clinical experience and/or utilization review experience. + Current active, valid...experience. + Current active, valid and unrestricted LPN/LVN or RN license and/or certification to practice as a health… more
    Elevance Health (10/07/25)
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