47 Utilization Management jobs in Florida, United States

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…

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.

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)

$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)

This is a remote position.

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)

$71.1–97.8K / year

Become a part of our caring community The Utilization Management Registered Nurse uses clinical nursing skills to interpret and support the…

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)

$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)

$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)

$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)

$38.00 – $44.00 / hour

Overview Who We Are Because health is personal.

United States (Remote)

$47.00 – $63.00 / hour

Thank you for considering a career at Ensemble!

United States (Remote)

$135.6–237.4K / year

Job Summary: The Director, Utilization Management Operations assists the UM Department with all open projects and progress towards company and…

United States (Remote)

$31.00 – $40.00 / hour

Job Title: Care Manager Department: Health Services What You’ll Do Develop and initiate client-centred, comprehensive Individual Care Plans…

United States (Remote)

Get To Know Us! WebTPA, a GuideWell Company, is a healthcare third-party administrator with over 30+ years of experience building unique benefit…

United States (Remote)

$79.3–127.1K / year

Company : Highmark Inc.