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6 utilization review case manager jobs at 3 companies in Orlando, FL

1mo
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Case Manager / PRN ( RN / RT / SW / LPN )
Orlando, Florida, United States
OnsiteTemporary, Contract
Select Specialty Hospital
Select Specialty Hospital: Private U.S. critical illness recovery hospital network treating medically complex patients needing extended post-acute care.
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.
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1mo
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Case Manager / PRN ( RN / RT / SW / LPN )
Orlando, Florida, United States
OnsiteTemporary
Select Specialty Hospital
Select Specialty Hospital: Private U.S. critical illness recovery hospital network treating medically complex patients needing extended post-acute care.
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.
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2mo
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RN, Utilization Management | Utilization Management| Variable | PRN
Leesburg, Florida, United States
OnsitePart Time, Temporary
UF Health Leesburg Hospital
UF Health Leesburg Hospital: A nonprofit acute-care hospital providing cardiovascular, surgical, emergency, stroke, and maternity care in Central Florida.
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.
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5d
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RN, Utilization Management| Day |Full Time
The Villages or Gainesville
OnsiteFull Time
UF Health The Villages Hospital
UF Health The Villages Hospital: Nonprofit 307-bed acute-care hospital serving residents of The Villages and patients across Lake, Sumter, and Marion counties.
3+ YOECurrent Florida RN license and at least 3 years of utilization review, utilization management, or case management experience. Requires knowledge of utilization guidelines, payer requirements, regulatory compliance, and care coordination.
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1mo
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Appeals and Grievances Clinical Specialist/ Quality Of Care
New York City or Lake Mary
$83k-$120k/yr HybridFull Time
HF Management Services, LLC
HF Management Services, LLC: Management employing staff for Healthfirst, a not-for-profit New York health insurer serving Medicaid, Medicare, and commercial members.
Active RN required; experience in clinical practice and appeals & grievances, claims processing, utilization review or case management; knowledge of utilization review guidelines and ability to manage large caseloads.
Microsoft Word, Microsoft Excel, Macess, CCMS, TruCare, Hyland, InterQual, Milliman
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1mo
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Appeals and Grievances Clinical Specialist/ Quality Of Care
New York or New York City or Lake Mary
$73k-$120k/yr RemoteFull Time
HF Management Services, LLC
HF Management Services, LLC: Management employing staff for Healthfirst, a not-for-profit New York health insurer serving Medicaid, Medicare, and commercial members.
Active RN required; experience in appeals & grievances, utilization review, or case management preferred; familiarity with utilization guidelines and ability to manage large caseloads under regulatory timeframes.
Microsoft Word, Microsoft Excel, Macess, CCMS, TruCare, Hyland, InterQual, Milliman
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