Top 65 Nurse case manager Jobs in Pensacola, Fl

Claims - Care Manager, RN, Claims
Wellcove —Pensacola, FL
- Full-time
- Remote
- RN License
- Mid-level
- Geriatrics
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Registered Nurse Case Management
Ascension —Pensacola, FL
- Full-time
- Nursing
- RN License
- Hospital
- Disability insurance
- Health insurance
RN Case Manager
HCA Florida West Hospital —Pensacola, FL
- Full-time
- No experience needed
- Critical & Intensive Care
- Children
- Employee stock purchase plan
- Disability insurance
Quick Apply
9d
Onsite Care Coordination Nurse
Humana —Pensacola, FL
- $71,100 - $97,800 a year
- Full-time
- Hybrid work
- Acute care
- Spanish
- Nursing
- Paid parental leave
- Paid holidays
Care Manager
Independent Living Systems —Pensacola, FL
- Full-time
- RN License
- Mid-level
- Master's degree
Quick Apply
Social Worker MSW
HCA Florida West Hospital —Pensacola, FL
- Full-time
- No experience needed
- Mid-level
- Critical & Intensive Care
- Employee stock purchase plan
- Disability insurance
Quick Apply
9d
RN-Case Manager Home Health
Peoples Home Health, LLC —Pensacola, FL
- CPR Certification
- Nursing
- RN License
- Continuing education credits
- Paid holidays
Quick Apply
Afterhours RN Care Manager (weekends)
Gentiva —Milton, FL
- Weekends as needed
- Background check
- CPR Certification
- Nursing
Quick Apply
RN Case Manager PRN
VITAS Healthcare —Pensacola, FL
- Full-time
- Skilled nursing facility
- RN License
- Mid-level
- Disability insurance
- Health insurance
Quick Apply
Hospice Facility RN Case Manager
Peoples Hospice and Palliative Care —Pensacola, FL
- PRN
- CPR Certification
- Nursing
- Skilled nursing facility
Quick Apply
Field Nurse Case Manager - Pensacola, FL
Opus Medical —Pensacola, FL
- Full-time
- Nursing
- RN License
- Mid-level
- Dental insurance
- Vision insurance
Quick Apply
Registered Nurse (weekends)
Gentiva —Pensacola, FL
- Weekends as needed
- Background check
- CPR Certification
- Nursing
Quick Apply
RN Case Manager Part Time
VITAS Healthcare —Pensacola, FL
- Full-time
- Skilled nursing facility
- RN License
- Mid-level
- Disability insurance
- Health insurance
Quick Apply
Clinical Liaison Home Health
Enhabit Home Health & Hospice —Pensacola, FL
- Full-time
- Nursing
- RN License
- Physical & Rehabilitation Medicine
- Health insurance
- Dental insurance
REGISTERED NURSE SPECIALIST - 64040063
The State of Florida —Pensacola, FL
- $50,000 - $58,500 a year
- On call
- Background check
- Nursing
- RN License
- Paid holidays
- Dental insurance
Palliative Care Registered Nurse (RN)
VITAS Healthcare —Pensacola, FL
- Full-time
- Bilingual
- Nursing
- RN License
- Disability insurance
- Health insurance
Quick Apply
Afterhours RN Care Manager
Gentiva —Pensacola, FL
- Weekends as needed
- CPR Certification
- Nursing
- RN License
Quick Apply
10d
Clinical Liaison
Centerwell —Pensacola, FL
- $59,300 - $80,900 a year
- Full-time
- Nursing
- RN License
- Computer literacy
- Paid parental leave
- Paid holidays
Registered Nurse
Gentiva —Pensacola, FL
- Call employer
- CPR Certification
- Nursing
- Medication administration
Quick Apply
Home Health RN Weekends
Peoples Home Health, LLC —Pensacola, FL
- CPR Certification
- Nursing
- RN License
- Continuing education credits
- Health insurance
Quick Apply

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nurse case manager jobs near pensacola, fl

Claims - Care Manager, RN, Claims

Wellcove
Pensacola, FL

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Job Details

Full-time

Qualifications

RN License

Full Job Description

Who We Are
Wellcove has been recognized as the nation’s leading full-service senior market solutions provider for over 25 years. Our solutions span the insurance senior market sector, focusing on long-term care and Medicare Supplement plans. However, we don’t stop there. Wellcove also addresses challenges faced in accident & health, disability, and supplemental health insurance programs.

Our team provides individuals and their families with peace of mind knowing their insurance needs will be met in a thoughtful, efficient manner. We are able to do this because of our dedicated associates, innovative solutions, and state-of-the-art technology.

We are seeking an experienced Registered Nurse (RN) to serve as a Care Manager supporting Long Term Care (LTC) insurance claims. This individual contributor role is responsible for conducting comprehensive clinical eligibility reviews to determine whether policyholders meet the benefit eligibility requirements outlined in their LTC policy.
The Care Manager, RN will complete and document Chronically Ill Certifications (CICs) and develop Plans of Care (POCs) for initial claims and ongoing recertifications, ensuring determinations are clinically sound, and policy aligned.

Key Responsibilities

Perform detailed clinical reviews of LTC claim files to determine eligibility in accordance with policy provisions and regulatory requirements.
Assess Activities of Daily Living (ADLs), cognitive impairment, diagnoses, comorbidities, and level of care needs.
Review medical records, Minimum Data Set (MDS) assessments, facility documentation, home health records, daily visit notes, and supporting claim forms.
Determine whether the insured meets the policy definition of Chronically Ill.
Prepare and document Chronically Ill Certifications (CICs) and individualized Plans of Care (POCs) for initial approvals and recertifications.
Clearly document clinical rationale to support benefit determinations.
Collaborate with Claims, Eligibility, and Customer Service teams to obtain additional documentation when necessary.
Maintain knowledge of LTC policy language, benefit triggers, and regulatory requirements.

Qualifications

Active, unrestricted Registered Nurse (RN) license required.
Clinical experience in long-term care, home health, geriatrics, case management, or utilization review preferred.
Experience reviewing medical records and assessing functional and cognitive impairment.
Knowledge of LTC insurance benefit triggers, ADL requirements, and chronically ill certification standards preferred.
Strong clinical judgment, critical thinking, and documentation skills.
Ability to manage multiple cases and meet turnaround expectations.

At Wellcove, we strive to create an inclusive culture for all. We understand the importance of listening and incorporating various perspectives at every level of service. Our company does not discriminate based on gender identity, race, sexual orientation, age, religion, or disability.

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Refine Your Search

nurse case manager jobs in pensacola, fl

Claims - Care Manager, RN, Claims

Registered Nurse Case Management

RN Case Manager

Onsite Care Coordination Nurse

Care Manager

Social Worker MSW

RN-Case Manager Home Health

Afterhours RN Care Manager (weekends)

RN Case Manager PRN

Hospice Facility RN Case Manager

Field Nurse Case Manager - Pensacola, FL

Registered Nurse (weekends)

RN Case Manager Part Time

Clinical Liaison Home Health

REGISTERED NURSE SPECIALIST - 64040063

Palliative Care Registered Nurse (RN)

Afterhours RN Care Manager

Clinical Liaison

Registered Nurse

Home Health RN Weekends

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