RN Utilization Review & Appeals Nurse
Molina Healthcare of Illinois
Molina Healthcare in Tampa, Florida is seeking a qualified Registered Nurse to conduct reviews of medical documentation to ensure compliance with healthcare regulations. The role demands at least 2 years of clinical nursing experience, including a year in utilization review. Responsibilities include facilitating medical reviews of claims, resolving utilization management complaints, and preparing cases for hearings. The company offers a competitive benefits and compensation package. #J-18808-Ljbffr
- ...Medical Management Clinician Associate - Licensed Nurse based in Tampa, FL. This full-time position is primarily... ...medical services based on guidelines, conduct reviews, and assess clinical information. A valid LPN/LVN or RN license is essential, alongside clinical...SuggestedRemote jobFull time
$29.05 - $67.97 per hour
...Description Job Summary Utilizing clinical knowledge and... ..., responsible for review of documentation to ensure... ...concurrent review of appeals for denied prior authorizations... ...least 2 years clinical nursing experience, including... ...• Registered Nurse (RN). License must be...SuggestedHourly payWork experience placementWork at office$29.05 - $67.97 per hour
...Job Summary Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical... ...concurrent review of appeals for denied prior... ...least 2 years clinical nursing experience, including... ...experience. Registered Nurse (RN). License must be...SuggestedHourly payWork experience placementWork at office- ...for a full‑time Clinical Research Infusion RN for their Magnolia location. The CRU... ...performing ongoing assessments, administering nursing care and protocol therapy, monitoring... ...) reports, unless they have successfully appealed to have their name removed. Applicants are...SuggestedFull time
- ...for a full timeClinical Research Infusion RN Ifor theirMagnolia location. The CRU at... ...performing ongoing assessments, administering nursing care and protocol-therapy, monitoring of... ..., unless the applicant has successfully appealed to have their name removed from the NPDB....SuggestedFull timeShift workDay shift
- ...and is currently looking for Registered Nurse to join our team. Position Highlights:... ...with 1 year of relevant experience FL RN License BLS Certification An... ...reports, unless the applicant has successfully appealed to have their name removed from the NPDB....
- ...basis and is currently looking for Registered Nurse to join our team. Position Highlights... ...institution with 1 year of relevant experience. FL RN License. BLS Certification. An applicant... ..., unless the applicant has successfully appealed to have their name removed from the NPDB....
- ...looking for a full-time Ambulatory Clinic RN for their McKinley location. The CRU at Moffitt... .... Position Highlights The Registered Nurse delivers individualized quality nursing care... ..., unless the applicant has successfully appealed to have their name removed from the NPDB....Full timeShift workDay shift
- ...Clinic is currently looking for a Registered Nurse to care for our patients seeking... ...Education: Master\'s Degree Registered Nurse (RN) – current licensure as a Registered Nurse... ...Bank (NPDB) reports, unless successfully appealed to have the name removed. An applicant is...Work at office
$65 per hour
...treatment and recovery. We are currently looking for an RN Temp Nurse to join our team. The Ideal Candidate ~ The ideal candidate... ...Bank (NPDB) reports, unless the applicant has successfully appealed to have their name removed from the NPDB. An applicant is...Hourly payContract workTemporary work- ...Clinical Research RN II Working at Moffitt is both a career and a mission: to contribute... .... Job Summary The Clinical Research Nurse II (CRN II) facilitates clinical research... ..., unless the applicant has successfully appealed to have their name removed from the NPDB....
- ...looking for a Full Time DAY Shift; Clinic Float Registered Nurse! The Clinic RN unit is dedicated to providing coverage for our Outpatient Oncology... ...Bank (NPDB) reports unless the applicant has successfully appealed to have their name removed from the NPDB. An applicant is...Full timeDay shift
- ...Department RN Navigators Schedule - Shift - Hours... ...continuum. Responsibilities Reviews External Records (pre-... ...the effectiveness of nursing interventions/actions... ...effective and efficient utilization of resources. Provides... ...applicant has successfully appealed to have their name...ReliefShift workDay shift
- ...RN Ambulatory Plastics And Reconstruction Nurse Working at Moffitt is both a career and a mission: to contribute to the prevention and cure of cancer.... ...NPDB) reports, unless the applicant has successfully appealed to have their name removed from the NPDB. An applicant...Work at office
- Overview: Under the direction of the director/charge person, the RN utilizes the nursing process, facilitates patient care making nursing assessments and diagnosis, formulates care plans based on the diagnosis and implements and evaluates the plan of care specific to Cardiac...Full time
- ...RN Advisor PRN Working at Moffitt is both a career and a mission: to contribute to... ...Highlights: The RN Advisor uses the nursing process to effectively plan and manage... ...reports, unless the applicant has successfully appealed to have their name removed from the NPDB....ReliefWork at office
- ...RN Advisor Working at Moffitt is both a career and a mission... ...doses and dose distributions Nursing specialists, nutritionists,... ...accreditation, we completed a rigorous review process that ensured proper... ...applicant has successfully appealed to have their name removed...
- ...seeking a skilled and motivated Plastic Surgery Nurse to support both surgical and non‑surgical... ...with 1 year of relevant experience FL RN License An applicant for this position,... ...reports, unless the applicant has successfully appealed to have their name removed from the NPDB....Work at office
- ...Registered Nurse (RN) | Long-Term Acute Care Location: Tampa, FL Agency: Access Healthcare LLC Pay: Competitive weekly pay (inquire for details) Shift Information: Nights - 3 days x 12 hours Contract Duration: 52 Weeks Start Date: ASAP...Weekly payDaily paidPermanent employmentFull timeContract workSummer workImmediate startShift workNight shift3 days per week
- ...Registered Nurse (RN) | Long-Term Acute Care Location: Tampa, FL Agency: Access Healthcare LLC Pay: Competitive weekly pay (inquire for details) Shift Information: Nights - 3 days x 12 hours Contract Duration: 52 Weeks Start Date: ASAP...Weekly payFull timeContract workSummer workImmediate startShift workNight shift3 days per week
- ...education to improve your skills. As a Registered Nurse at Ambulatory Surgery Center Tampa, you’ll... ...need: Associate Degree in Nursing or RN Diploma or Higher degree in Nursing... ...PACU RN opening. Our team will promptly review your application. Highly qualified candidates...Temporary workFlexible hours
$2,070 per week
...Registered Nurse (RN) | Home Health Location: Oldsmar, FL Agency: Core Medical Group Pay: $2,070 per week Shift Information: Days Contract Duration: 13 Weeks Start Date: 6/29/2026 About the Position TravelNurseSource is working with...Weekly payDaily paidPermanent employmentFull timeContract workTemporary workRelocationFlexible hoursShift workWeekend work2 days per week$1,203 - $1,389 per week
...Registered Nurse (RN) | Home Health Location: Lutz, FL Agency: National Staffing Solutions Pay: $1,203 to $1,389 per week Contract Duration: 2 Weeks Start Date: ASAP About the Position Details of the RN - Home Health (HH) opening in Lutz,...Full timeContract workImmediate startNight shift$2,057 per week
...Registered Nurse (RN) | Post-Anesthesia Care Unit (PACU) / Pre-Post Op Location: Tampa, FL Agency: THP Healthcare Staffing Pay: $2,057 per week Shift Information: Days - 3 days x 12 hours Contract Duration: 12 Weeks Start Date: 6/15/2026...Extra incomeFull timeContract workShift workDay shift$1,749 per week
...Registered Nurse (RN) | Labor & Delivery Location: Tampa, FL Agency: Health Advocates Network Pay: $1,749 per week Shift Information: 3 days x 12 hours Start Date: ASAP About the Position RN – Labor and Delivery L&D Registered Nurse - Health...Daily paidFull timeImmediate startShift workNight shift$1,749 per week
...Registered Nurse (RN) | Labor & Delivery Location: Tampa, FL Agency: Health Advocates Network Pay: $1,749 per week Shift Information: 3 days x 12 hours Start Date: ASAP About the Position TravelNurseSource is working with Health Advocates...Daily paidFull timeImmediate startShift workNight shift$1,203 - $1,389 per week
...Registered Nurse (RN) | Home Health Location: Lutz, FL Agency: National Staffing Solutions Pay: $1,203 to $1,389 per week Shift Information: Days - 3 days x 12 hours Contract Duration: 2 Weeks Start Date: ASAP About the Position TravelNurseSource...Full timeContract workImmediate startShift work$2,057 per week
...Registered Nurse (RN) | Post-Anesthesia Care Unit (PACU) / Pre-Post Op Location: Tampa, FL Agency: THP Healthcare Staffing Pay: $2,057 per week Shift Information: Days - 3 days x 12 hours Contract Duration: 12 Weeks Start Date: 6/15/2026...Extra incomeFull timeContract workShift workDay shift$33.37 - $45.05 per hour
...Florida is seeking an experienced Pediatric/Neonatal Critical Care RN to join our highly specialized transport team. In this role,... ...Deliver care aligned with ANA standards and the Florida Nurse Practice Act Support continuous improvement and deliver exceptional...Full timeRelocation packageFlexible hoursShift work- ...the growth and development of our future nurses! The HCA Nurse Residency Program is a... ...evidence-based practice project. The RN Resident coordinates and delivers high quality... ...and personal growth, we promptly review all applications. Unlock the possibilities...Temporary workFlexible hoursShift work
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