43 Utilization Review jobs in Florida, United States

Florida, US (Hybrid)

$71.2–115.7K / year

The CRN is responsible for performing medical reviews using established criteria to ensure the member is receiving care at the most appropriate level.

Florida, US (Hybrid)

$71.2–115.7K / year

The CRN is responsible for performing medical reviews using established criteria to ensure the member is receiving care at the most appropriate level.

Florida, US (Hybrid)

$25.00 – $41.00 / hour

The Administrative Nurse, LPN will support Clinical Review/Utilization Management processes in pre-service medical review, post-service medical…

Florida, US (Hybrid)

$25.00 – $41.00 / hour

The Administrative Nurse, LPN will support Clinical Review/Utilization Management processes in pre-service medical review, post-service medical…

United States (Remote)

Overview The Manager, Utilization Review Nursing is responsible for the operational oversight and leadership of Sendero Health Plans’ Utilization…

United States (Remote)

$63.1–94.7K / year

Thank you for considering a career at Ensemble!

United States (Remote)

$63.1–94.7K / year

Thank you for considering a career at Ensemble!

United States (Remote)

$47.00 – $63.00 / hour

Thank you for considering a career at Ensemble!

United States (Remote)

$38.00 – $44.00 / hour

Overview Who We Are Because health is personal.

United States (Remote)

$35.00 – $40.00 / hour

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw…

United States (Remote)

$82.7–96.5K / year

Job Description A bit about this role: The Clinical Guide Part A will be part of the Utilization Management team, responsible for inpatient,…

United States (Remote)

$70.2–105.3K / year

Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond.

United States (Remote)

$70–75K / year

The Utilization Management Registered Nurse is responsible for performing utilization review activities in compliance with federal and state…

United States (Remote)

This is a remote position.

United States (Remote)

$100–130K / year

At Clover Health, we are committed to providing high-quality, affordable, and easy-to-understand healthcare plans for America’s seniors.

United States (Remote)

$80K / year

Applicants must reside in: Michigan, Florida, Idaho, Texas, Minnesota or Illinois.

United States (Remote)

$75.3–135.4K / year

Position Purpose: Supervises Prior Authorization, Concurrent Review, and/or Retrospective Review Clinical Review team to ensure appropriate care to members.

United States (Remote)

$65–70K / year

Scope: The Medical Review Specialist is a Registered Nurse who conducts the Utilization Review process by obtaining medical information and…

United States (Remote)

$31.00 / hour

At Broadway Ventures , we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions.

United States (Remote)

$78–88K / year

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges.