37 utilization review case manager jobs at 25 companies in Florida
2w
Save
Mark Applied
Hide
Case Manager, RN- Utilization Review
Tampa, Florida, United States
$36/hr RemoteFull Time
3+ YOEFlorida RN license and three years of practicing RN experience required. Utilization management experience preferred. Requires utilization review expertise, medical necessity assessment, payer collaboration, documentation, and Microsoft applications.
InterQual, Electronic Medical Records (EMR), utilization management systems, Microsoft Outlook, Microsoft Teams, Microsoft Word, Microsoft Excel
1w
Save
Mark Applied
Hide
Utilization Review Specialist
Jacksonville, Florida, United States
OnsiteFull Time
2+ YOEBachelor's degree in nursing, health administration, or a related healthcare field; 2+ years in utilization review, case management, or clinical healthcare; medical terminology, regulations, authorization, and reimbursement knowledge.
Electronic Health Records (EHR), utilization management software, Voya, Cognitive Behavioral Therapy (CBT) modules
1w
Save
Mark Applied
Hide
Utilization Review Specialist
Jacksonville, Florida, United States
OnsiteFull Time
2+ YOEBachelor's degree in nursing, health administration, or related healthcare field; 2+ years in utilization review, case management, or clinical healthcare; knowledge of medical terminology, regulations, insurance authorization, and reimbursement.
Electronic Health Records (EHR), utilization management software, healthcare IT systems
2w
Save
Mark Applied
Hide
Utilization Management Nurse, PRN, Downtown
Jacksonville, Florida, United States
HybridPart Time
3+ YOE3+ years case management experience required, Associates degree required. Perform concurrent record monitoring, utilization review per regulations, assist with discharge planning and case management, and provide utilization information to payers.
1mo
Save
Mark Applied
Hide
Supervisor, Utilization Management
Phoenix or Alaska or Arkansas or Arizona or Colorado or Florida or Hawaii or Iowa or Idaho or Illinois or Kansas or Louisiana or Maryland or Minnesota or Missouri or Montana or Nebraska or Nevada or New Mexico or North Carolina or North Dakota or Oklahoma or Oregon or South Carolina or South Dakota or Tennessee or Texas or Utah or Virginia or District of Columbia or Washington or Wisconsin or Wyoming
$91k-$107k/yr RemoteFull Time
3+ YOE3+ MgmtCurrent RN license, 3+ years healthcare experience, 3+ years supervisory experience, 2+ years utilization review/case management, U.S. citizenship and favorable DoD background investigation required.
InterQual, ICD, DSM, CPT, HCPCS, American Dental codes, Microsoft Office, Microsoft Word, Microsoft Outlook, TriWest Intranet
3w
Save
Mark Applied
Hide
Utilization Management Nurse
Florida, United States
$71k-$98k/yr RemoteFull Time
3+ YOEActive Florida RN (or LPN) license with no disciplinary action, RN with 3+ years clinical experience (LPN 5+ years), Florida residency, experience in utilization management/authorizations and case management preferred, familiarity with MCG and durable medical equipment review, BSN preferred.
MCG
4d
Save
Mark Applied
Hide
BPO Clinical Review Specialist
Jacksonville, Florida, United States
$76k/yr RemoteFull Time
3+ YOERequires 3 years in appeals, utilization management, case management, or clinical review; active unencumbered Florida or compact RN license; clinical assessment, medical necessity review, documentation, and communication skills.
1mo
Save
Mark Applied
Hide
Case Manager
Naples, Florida, United States
OnsiteFull Time
Must be a licensed clinician in eligible discipline, eligible for or obtain CCM/ACM within two years, assess and coordinate care, and participate in utilization review and discharge planning.
1w
Save
Mark Applied
Hide
RN Case Manager
Weston, Florida, United States
OnsiteFull Time
3+ YOEProfessional nursing graduate with current RN licensure, BLS certification, and three years of recent RN clinical experience; care management or utilization review experience preferred.
CMS Conditions of Participation
2mo
Save
Mark Applied
Hide
Review Nurse- Value Based Services
Clearwater, Florida, United States
OnsiteFull Time
2+ YOELPN required with 2+ years LPN experience and 1+ year utilization review/case management experience; active Florida LPN license and current BLS; ability to conduct clinical reviews, patient outreach, documentation, and use HEDIS/quality measures.
HEDIS
1mo
Save
Mark Applied
Hide
Utilization Management Specialist – Acute Care
Naples, Florida, United States
OnsiteFull Time, Part Time
1+ YOEHigh school diploma and 1+ year experience in utilization review, authorizations, case management or related field; EHR and payer portal experience; strong documentation, organizational, and HIPAA knowledge; ability to pass fingerprint, drug screen, and background check.
Electronic Health Records (EHR), Microsoft Office 365, Microsoft Teams, payer portals
1mo
Save
Mark Applied
Hide
Case Manager (H)
Hialeah, Florida, United States
OnsiteFull Time
Conduct utilization and discharge reviews, coordinate multidisciplinary care, obtain authorizations and precertifications, perform financial clearance for transplants, and ensure documentation to maximize reimbursement.
UChart
1w
Save
Mark Applied
Hide
Healthcare Svcs Review Nurse
Tampa, Florida, United States
$33-$60/hr OnsiteFull Time
5+ YOEFlorida RN license, Florida driver's license, five years of medical or surgical nursing experience, including two years in quality assurance, utilization review, or case management.
Microsoft Excel, Microsoft Word, National Committee on Quality Assurance (NCQA), Florida Department of Law Enforcement (FDLE), Criminal Justice Information Services (CJIS), State Automated Child Welfare Information System (SACWIS)
1mo
Save
Mark Applied
Hide
Nurse Case Manager
Daytona Beach, Florida, United States
OnsiteFull Time
3+ YOECompletion of an accredited LPN or RN program, licensed in Florida, 3 years acute care experience, utilization review experience preferred, strong communication, time management, computer and patient advocacy skills.
1mo
Save
Mark Applied
Hide
Case Manager / PRN ( RN / RT / SW / LPN )
Orlando, Florida, United States
OnsiteTemporary, Contract
Current clinical license (RN/LPN/LVN/RT) or social work license (SW/MSW); previous inpatient discharge planning/case management experience preferred; ability to develop discharge plans, utilization review, and coordinate payor resources.
1mo
Save
Mark Applied
Hide
Case Manager / PRN ( RN / RT / SW / LPN )
Orlando, Florida, United States
OnsiteTemporary
Current clinical licensure (RN/LPN/LVN/RT or state social work license), prior inpatient experience with critical/acute care patients, acute medical case management and discharge planning experience, knowledge of utilization review and payer reimbursement.
1w
Save
Mark Applied
Hide
CASE MANAGER (RN/LIC)
West Palm Beach, Florida, United States
OnsitePart Time
2+ YOEFlorida RN with 2–4 years of recent acute care experience, utilization chart review and discharge planning experience, strong clinical and communication skills, InterQual Criteria knowledge, and basic computer skills.
InterQual Criteria
2mo
Save
Mark Applied
Hide
RN, Utilization Management | Utilization Management| Variable | PRN
Leesburg, Florida, United States
OnsitePart Time, Temporary
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.
1w
Save
Mark Applied
Hide
RN Community Case Manager
North Miami Beach, Florida, United States
$37-$53/hr OnsiteFull Time
2+ YOEActive RN license, 2+ years clinical experience, 1+ year utilization review or case management experience, BLS, driver's license, and proficiency with Microsoft Office. English fluency required.
Microsoft Office Suite, Microsoft Excel, Microsoft Word, Microsoft PowerPoint, Microsoft Outlook, Electronic Medical Records (EMR)
1w
Save
Mark Applied
Hide
Registered Nurse Utilization Review, Case Management, Per Diem, 8:30A-5P/Shift Varies
Miami, Florida, United States
OnsitePart Time
3+ YOERequires an RN license and 3 years of experience. An associate degree is required; hospital clinical experience, payer reimbursement knowledge, communication, analytical, and chart review skills are preferred.
Explore Jobs
Expand Your Job Search
Top Cities in Florida for Utilization Review Case Manager
- Utilization Review Case Manager jobs in Jacksonville, FL
- Utilization Review Case Manager jobs in Miami, FL
- Utilization Review Case Manager jobs in Tampa, FL
- Utilization Review Case Manager jobs in Orlando, FL
- Utilization Review Case Manager jobs in St. Petersburg, FL
- Utilization Review Case Manager jobs in Hialeah, FL
- Utilization Review Case Manager jobs in Tallahassee, FL
- Utilization Review Case Manager jobs in Fort Lauderdale, FL
- Utilization Review Case Manager jobs in Cape Coral, FL
- Utilization Review Case Manager jobs in Pembroke Pines, FL
- Utilization Review Case Manager jobs in Port Saint Lucie, FL
- Utilization Review Case Manager jobs in Hollywood, FL
- Utilization Review Case Manager jobs in Gainesville, FL
- Utilization Review Case Manager jobs in Miramar, FL
- Utilization Review Case Manager jobs in Coral Springs, FL
- Utilization Review Case Manager jobs in Palm Bay, FL
- Utilization Review Case Manager jobs in Miami Gardens, FL
- Utilization Review Case Manager jobs in Clearwater, FL
- Utilization Review Case Manager jobs in Pompano Beach, FL
- Utilization Review Case Manager jobs in West Palm Beach, FL