331 utilization jobs at 165 companies in Dade City, FL
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HEDIS Utilization Review Nurse
Winter Haven, Florida, United States
OnsiteFull Time
Central Florida Health Care: Provider of integrated medical, dental, and behavioral healthcare services.
2+ YOERequires Florida nursing license, BLS,2+ years clinical experience, HEDIS/ utilization review or chart abstraction experience preferred, EHR proficiency, strong communication and analytical skills.
Department of Veterans Affairs: Provides healthcare, benefits, and cemetery services to military veterans.
1+ YOEOne year specialized experience in healthcare contracting and procurement, familiarity with FAR/VAAR, ability to prepare procurement packages and support contract administration; U.S. citizenship and selective service compliance required.
BayCare Health System: Operates non-profit hospitals and outpatient healthcare facilities in Florida.
5+ YOEDoctorate (MD/DO) with medical board license, 5 years clinical experience, 1 year education experience; performs observation and secondary reviews, collaborates with case management and clinical providers, and uses Cerner and Microsoft Teams.
SECUR Health Plan: Provider of specialized Medicare Advantage health plans for individuals with complex needs.
2+ YOEActive RN or LPN license, 2+ years clinical nursing experience, EMR/EHR experience, Microsoft Office proficiency, case management certification preferred.
Electronic Medical Records (EMR), EHR, Microsoft Office
Central Florida Behavioral Health Network: A non-profit managing entity for public behavioral health services.
2+ YOEMaster's in social work/mental health counseling/MFT; active behavioral health license (LMHC, LCSW, or LMFT); minimum 2 years utilization management experience; Microsoft Office skills; ability to travel up to 25%.
Clean Recovery Centers: Provides addiction treatment and mental health recovery services.
Manage insurance authorizations, review medical necessity and records, navigate EMRs and payer portals, communicate with clinicians and payors, and track denials; high school diploma and attention to detail required.
EMR, payspan, zelis, Microsoft Word, Microsoft Outlook, Microsoft Excel, Adobe, InterQual, ASAM, LOCUS
UF Health: Academic health center providing clinical care and medical education.
3+ YOECurrent Florida RN license; minimum 3 years experience in utilization review/management or case management; knowledge of utilization guidelines, payer requirements, and regulatory compliance; strong communication and data-analysis skills.
City of Lakeland: Provides municipal services, public utilities, and safety for Lakeland.
4+ YOEHigh school diploma/GED and 4+ years journeyman-level industrial mechanical/electrical/instrument experience (internal candidates: 5 years apprenticeship). Must hold valid driver\u0001s license, pass respirator/fit testing, and have intermediate computer skills (Microsoft Office, MAXIMO preferred).
Microsoft Excel, Microsoft Word, Microsoft Outlook, MAXIMO
City of Tampa: A municipal department responsible for operating and maintaining stormwater pump stations and related infrastructure.
5+ YOEHigh school diploma/GED plus 5 years experience in mechanical/electrical/plumbing/industrial maintenance or water/wastewater systems; ability to read technical manuals and schematics; valid driver’s license; confined space work and heavy lifting.
Universal Health ServicesNYSE: UHS: Operates acute care hospitals and behavioral health facilities.
3+ YOEMaster’s degree in psychology, mental health counseling, social work or related field; Florida license preferred; 3-5 years chart analysis/utilization review experience; strong communication skills.
Children's Home Network: Provides residential care, foster care, and family support services.
2+ YOEHigh school diploma (or equivalent) plus 2 years as an Intake/Data Coordinator (associates or bachelor's may substitute). Must hold valid Florida driver credentials, pass FDLE/federal/state background checks and sexual predator screening, and complete required annual trainings.
Myevolv, Microsoft Word, Microsoft Excel, Microsoft Publisher, Microsoft PowerPoint
New York City or Milwaukee or Herndon or Dallas or Columbus or Kirkland or Irvine or Cincinnati or Cleveland or Oklahoma City or Austin or Albany or Chicago or Arlington or St. Petersburg or Hartford or Pittsburgh or St. Louis or Miami or Sacramento or Raleigh or Minneapolis or Mountain View or Scottsdale or Morristown or San Francisco or Denver or Boston or Philadelphia or Des Moines or Overland Park or Los Angeles or Charlotte or Walnut Creek or Carmel or Seattle or Houston or Arlington or Atlanta or Redmond or Bentonville or Beaverton or Nashville or Detroit or San Diego
$139k-$434k/yrHybridFull Time
AccentureNYSE: ACN: Global provider of management consulting and technology services.
10+ YOE10+ years in utility GIS solution architecture with full‑lifecycle ArcGIS Utility Network implementations; experience advising utility executives, defining enterprise GIS architecture, and leading large transformation programs; must be eligible to work in the US and willing to travel.
Wire 3: Provides high-speed fiber-optic internet services to Florida communities.
High school diploma/GED, valid driver\u0002s license, ability to pass DOT drug/alcohol testing, experience in utility locating or underground construction preferred, familiarity with utility locating equipment and GIS preferred.
George F. Young: Civil engineering and land surveying for property development.
10+ YOE10+ years FDOT utility coordination experience, strong FDOT/FHWA/AASHTO knowledge, proven business development success, established FDOT and utility relationships, MS Office and Adobe proficiency, valid U.S. driver’s license.
LCS: A retirement community employer providing culinary and hospitality services in an upscale senior living environment.
High school diploma or equivalent preferred; six months dishwashing/utility experience preferred but not required; must be available for all shifts and perform physical tasks.