Care Review RN: Utilization & Care Coordination (FL)
$26.41 - $51.49 per hourMolina Healthcare of Illinois
Molina Healthcare in California, MO is seeking a Clinical Member Services Reviewer. The role includes assessing clinical service requests, ensuring compliance with regulations, and collaborating with teams for healthcare delivery. The ideal candidate has an active RN license and at least 2 years of experience in hospital or managed care settings. Competitive pay is offered, ranging from $26.41 to $51.49 hourly based on experience and skills. #J-18808-Ljbffr
$73.86k - $96.02k
...concurrent, retrospective chart review for clinical financial resource utilization. Coordinates with the healthcare team for optimal... ...Licenses & Certifications: MCG Care Guidelines Specialist.... ...their non-leadership role as an RN. However, they are required to complete...SuggestedLocal area- ...is seeking a dedicated Utilization Management professional... ...licensure as either an LPN or RN and a minimum of 2 years... ...include reviewing patient clinical information, coordinating with healthcare teams, and... ...on teamwork and patient care. #J-18808-Ljbffr Itlearn...SuggestedFull time
$62.7k - $100.4k
A healthcare organization is seeking a Clinical Care Reviewer II responsible for processing medical necessity reviews and assisting with care coordination activities. Candidates need to hold an Associate's degree in nursing and have at least three years of clinical experience...Suggested$73.86k - $96.02k
Baptist Health South Florida is seeking a qualified individual to conduct chart reviews for clinical financial resource utilization. The role requires effective communication with healthcare teams and various agencies to optimize patient outcomes. Qualifications include...Suggested- ...highest quality in‑home care services that improve... ...You Be Doing Concurrent review of patient’s clinical... ...for medical necessity Coordinates patient care needs with... ...updates to Manager of Utilization Management for review... ...licensure as a LPN or RN Minimum 2 years of prior...SuggestedFull timeTemporary work
$26.41 - $51.49 per hour
...for clinical member services review assessment processes. Responsible... ...integrated delivery of care across the continuum. Contributes... ...Molina care model. Adheres to utilization management (UM) policies and procedures... ...experience. Registered Nurse (RN). License must be active and...Hourly payWork experience placementWork at officeRemote work- ...healthcare services company is seeking a Clinical Care Reviewer based in Doral, FL. The role requires a current FL RN licensure and a minimum of 3 years of nursing... ...or ICU. Candidates should have experience with Utilization Review, familiarity with Interqual Criterion,...
$71.1k - $97.8k
...insurance company is seeking a Utilization Management Registered Nurse to utilize... ...clinical nursing skills for coordinating medical services and benefit... ...clinical experience and a Compact RN license. Responsibilities include making care determinations, excellent communication...Remote job- RN- Home Care Infusion Nurse job at NurseCore. New Port Richey, FL. NurseCore is currently hiring Registered Nurses (RN) with Infusion experience for our Specialty... .... Follows proper infection controlmeasures. Coordinates the planning for delivery of nursing care with...Weekly payDaily paidCurrently hiringWork at officeFlexible hoursShift work
$40 per hour
Nurse Reviewer PT (20‑30 hours week) - Remote Work Environment Non‑Exempt... ...and regulations. The RN will work closely with the Team... ...with established standards of care and applicable policies Manage... ...claims against industry standards, utilizing research of relevant ICD‑10,...Contract workWork at officeLocal areaImmediate startRemote work$62.7k - $100.4k
Job Summary Clinical Care Reviewer II is responsible for processing medical... ...health services) and care coordination for members, as well as... ...accredited registered nursing (RN) degree program required... ...health experience preferred Utilization Management/Utilization Review...Hourly payWork at office$65.58k - $108.65k
...Description Delivers safe care and demonstrates regard... ..., the Institutional Review Board, and the Office of Sponsored Programs. Coordinates the work of support staff... ...to maintain licensure. Utilizes positive interpersonal... ...Registered Nurse (RN) [Required] Basic Life...Full timeWork experience placementWork at officeLocal areaFlexible hoursShift work$64k - $70k
Location: Hollywood, FL (In Office) Schedule: Full-Time Salary: $64,000 - $70,000 per year... ...to delivering high-quality, proactive care directly to residents in skilled nursing and... ...In this role, you will be responsible for reviewing patient charts and communicating with the...Full timeContract workFor contractorsFor subcontractorWork at office- The MedElite Group is looking for a responsible LPN Care Coordinator in Hollywood, FL, to ensure the accuracy of patient records and collaborate with the team to provide high-quality care. This is a full-time in-office role that requires an LPN certificate and excellent...Hourly payFull timeWork at office
- ...Nurse- Hospice (Patient Care Coordinator) page is loaded##... ...Coordinator)locations: US-FL-Port Orangetime type:... ...Currently licensed as an RN in State of Florida. -... ...- Manages and reviews the budget for errors... ...Performance Improvement and Utilization Review functions.locations...
- ...50, Ste 101, Clermont, FL 34711February 24, 2026###... ...Nurse (BHRN)****Angels Care Home Health**Angels... ...to home bound patients. Coordinates care with the interdisciplinary... ...OASIS within 48 hours* Utilize appropriate behavioral... ...to QA and coder reviews and performing clinical...
$28.27 - $50.48 per hour
...global organization that delivers care, aided by technology to help... ...Differential *BLS Renewal reimbursement *FL Licensure Reimbursement *... ...: Active, unrestricted RN license in the state of Florida... ...infusion competency Ability to utilize Microsoft programs including MS...Hourly payMinimum wageFull timePart timeWork experience placementLocal areaFlexible hoursShift workWeekend work- ...professional nursing care in accordance with... ...care activities, coordinates care planning, collaborates... ...in Coral Springs, Fl. Job Specific... ...repositioning. Reviews patient admission history... ...(AD in Nursing, RN Diploma, or BSN);... ...interpret data and utilize the information to...Daily paidFlexible hoursShift workNight shift
- A healthcare provider in Port Orange, FL is seeking a Registered Nurse for Hospice care. The role involves coordinating care for terminally ill patients, performing ongoing assessments... ...education. Candidates must be licensed as an RN in Florida and possess strong interpersonal...Full timeNight shift
- ...Hospital at Home Program (Weston FL) Activa Home Health is... ...program, delivering hospital-level care to patients in their homes as... ...hospital partner while receiving coordinated in-home care supported by... ...For further information, please review the Notice from the Department...
$71.1k - $97.8k
Job Summary The Utilization Management Registered Nurse uses... ...and support the coordination, documentation and communication... ...manages post-acute care services, including Skilled... ...Registered Nurse (RN) license in your state... ...management/utilization review for a health plan or acute...Bi-weekly payTemporary workRemote work- Emergency Room Registered Nurse (RN) We are seeking a highly skilled and resilient RN for... ...Charting System: EPIC Location: Vero Beach, FL Local Rule: Locals accepted at same rate... ...experience with high-acuity emergency or trauma care Proficiency in EPIC charting Simple,...Local areaShift workNight shiftWeekend work
- ...staffing firm is seeking a Registered Nurse for Concurrent Review in Florida. The role involves telephonic review of... ...to ensure appropriate medical necessity and care levels. Candidates must have an active RN license in Florida and 2+ years of clinical experience...Full timeWork at officeMonday to Friday
$80k - $90k
...Responsibilities*** Performs clinical reviews on medical records to maintain... ...necessary.* Experience with utilization management systems or clinical... ...making tools such as Millimen Care Guidelines (MCG) or InterQual.... ...*** Active unrestricted RN license #J-18808-Ljbffr Performant...Remote workFlexible hours- ...roles in the Southeast Region, including states like FL and GA. Responsibilities include coordinating care for chronically ill members, assessing patient needs,... ...various stakeholders. Candidates must have an active RN licensure and at least 3 years of clinical experience...
- ...Remote 4023 Tampa Rd Oldsmar, FL 34677, USA Are you looking to... ...most -- at home. Pinnacle Home Care Holdings, LLC ("Pinnacle") is... ...an experienced Clinical Review Specialist to join our growing... ...Partner closely with Intake, Care Coordination, and Branch leadership to ensure...Work at officeRemote workHome office
$61.86k - $96.66k
## RN, Care CoordinatorApplylocations: Tavares, FLtime type: Full timeposted on: Posted Todayjob requisition id: R261... ...responsible for assessing and identifying patient/family needs, utilizing the nursing process, coordinating the Plan of Care with the Interdisciplinary Team (IDT)...Local areaImmediate startNight shift- ...community-based hospitals, a long-term acute care facility, home health services,... ...and clinical excellence. Hospital Care Coordinator‑RN Case Management Responsibilities Provides... ...Location: North Bay Hospital - New Port Richey, FL Status: PRN, As Needed Schedule: Days...ReliefWeekend work
- Background Screening Information - Position Summary The RN Unit Care Coordinator is responsible for supervising, implementing, coordinating, and managing patient care through interpersonal contact with patients, families, nursing staff, and others on his/her respective...
$33 - $39 per hour
.../hr The VITAS Telecare RN is a member of the interdisciplinary... ...and families by utilizing the nursing process, the VITAS Palliative Care Guide, and Telecare... ...with LPN/LVN’s. Coordinates all service delivery after... ...patient/family interaction. Reviews all entries in the...Contract workWeekend work
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