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5 utilization review case manager jobs at 4 companies in Jacksonville, FL

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Utilization Review Specialist
Jacksonville, Florida, United States
OnsiteFull Time
Bradford Health Services
Bradford Health Services: Provider of substance use disorder treatment and recovery services.
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
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Utilization Review Specialist
Jacksonville, Florida, United States
OnsiteFull Time
Bradford Health Services
Bradford Health Services: Provider of substance use disorder treatment and recovery services.
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
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BPO Clinical Review Specialist
Jacksonville, Florida, United States
$76k/yr RemoteFull Time
NTT DATA
NTT DATATokyo Stock Exchange: 9613: Global digital business and IT services provider.
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.
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Part-Time Concurrent Review RN - Every Saturday and Sunday
Jacksonville, Florida, United States
$71k-$116k/yr HybridPart Time
Florida Blue
Florida Blue: Not-for-profit mutual health-services holding providing insurance, care, and administrative solutions to consumers, employers, and government programs.
2+ YOERequires 2+ years related clinical experience, unrestricted US RN license with Florida or compact licensure, related bachelor's degree or equivalent experience, and utilization review, discharge planning, case management, or facility experience.
InterQual, Microsoft Word, Microsoft Excel
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Clinical Appeals Specialist II-Hybrid
Rochester or Phoenix or Scottsdale or Jacksonville
$88k-$124k/yr HybridFull Time
Mayo Clinic (Rochester)
Mayo Clinic (Rochester): Nonprofit academic medical center providing integrated patient care, medical education, and biomedical research.
3+ YOEAssociate degree, 3 years of relevant nursing experience, and active unrestricted RN license required. Appeals, coding, utilization review, and case management experience preferred.
Milliman Care Guidelines, InterQual Criteria, Epic, Microsoft Office Suite, ICD-10-CM/PCS
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