Top 46 Utilization review nurse Jobs in Oldsmar, Fl

RN Utilization Review - Full Time Days
Moffitt Cancer Center —Tampa, FL
- $77,022.40 - $117,582.40 a year
- Full-time
- Hybrid work
- Acute care
- Nursing
- RN License
1d
Healthcare Svcs Review Nurse
Hillsborough County, Florida —Tampa, FL
- $32.84 - $60.18 an hour
- Background check
- Spanish
- RN License
7d
Care Review Clinician (RN) - Remote in FL
Molina Healthcare —Tampa, FL
- $26.41 - $51.49 an hour
- Full-time
- Remote
- RN License
- Mid-level
- Critical & Intensive Care
- Health insurance
RN Care Manager - FGC Market
ArchWell Health —Clearwater, FL
- Full-time
- Nursing
- RN License
- Mid-level
MDS Coordinator RN or LPN
the oaks of clearwater —Clearwater, FL
- From $70,000 an hour
- Full-time
- RN License
- Medical office experience
- HIPAA
- Health insurance
- Dental insurance
Quick Apply
14d
Director of Nursing
Brave Kidz —Tampa, FL
- $90,000 - $105,000 a year
- Full-time
- Spanish
- CPR Certification
- Nursing
- Health insurance
- Dental insurance
Quick Apply
20h
Registered Nurse Case Manager-Certified
ERP International, LLC —Tampa, FL
- $40 - $44 an hour
- Online Application
- Background check
- Nursing
- RN License
- Health savings account
- Paid holidays
Quick Apply
13d
Nurse Case Manager
Battelle —Tampa, FL
- Full-time
- Hybrid work
- Nursing
- RN License
- BLS Certification
- Wellness program
- Health insurance
Care Review Clinician, Specialty Therapist (Occupational / Physical / Speech) - REMOTE from Florida
Molina Healthcare —Tampa, FL
- $26.41 - $51.49 an hour
- Full-time
- Remote
- Physical & Rehabilitation Medicine
- Mid-level
- Physical Therapy License
- Health insurance
Clinical Navigator
Paradigm Corp —Tampa, FL
- $73,000 - $88,000 a year
- Full-time
- Remote
- Spanish
- RN License
- Customer service
- Health savings account
- Paid holidays
10d
Utilization Review Specialist Senior
BayCare —Tampa, FL
- Weekends as needed
- Hybrid work
- Nursing
- RN License
- Hospital
- Tuition reimbursement
- 401(k) matching
(Part-Time) Legal Nurse Case Reviewer | Orthopaedics / Neurosurgery | Onsite
Shimspine —Oldsmar, FL
- Part-time
- Nursing
- RN License
- 5 years
- Paid training
- Flexible schedule
Quick Apply
Care Review Clinician (BH Licensed) - Remote in FL
Molina Healthcare —Tampa, FL
- $26.41 - $51.49 an hour
- Full-time
- Remote
- LMFT
- Licensed Clinical Social Worker
- Mid-level
- Health insurance
Onsite Care Coordination Nurse
Humana —Clearwater, FL
- $71,100 - $97,800 a year
- Full-time
- Hybrid work
- Acute care
- Spanish
- Nursing
- Paid parental leave
- Paid holidays
2d
RN Case Manager PRN Days
Moffitt Cancer Center —Tampa, FL
- $44.25 an hour
- Weekends as needed
- Nursing
- RN License
- BLS Certification
14d
Utilization Reviewer 2
Enlyte —Tampa, FL
- $59,500 - $76,000 a year
- Full-time
- RN License
- Mid-level
- Office
- Health savings account
- AD&D insurance
Medical Case Manager I
CorVel Corporation —Tampa, FL
- $63,739 - $95,264 a year
- Full-time
- Remote
- Nursing
- RN License
- Computer literacy
- Health savings account
- Disability insurance
Quick Apply
Clinical Nurse Reviewer
Zelis —Saint Petersburg, FL
- $59,000 - $75,050 a year
- Full-time
- Nursing
- RN License
- Inventory management
- Paid holidays
- Disability insurance
Electronic Medical Records Coordinator
Blue Heron —Wesley Chapel, FL
- Full-time
- Mid-level
- LPN
- Health insurance
- Dental insurance
Quick Apply
Care Manager
AaNeel Infotech —Tampa, FL
- $65,000 - $80,000 a year
- Full-time
- Spanish
- English
- Mid-level
- Health insurance
- Dental insurance

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utilization review nurse jobs near oldsmar, fl

RN Utilization Review - Full Time Days

Moffitt Cancer Center -
Tampa, FL

Apply Now

Job Details

Full-time
$77,022.40 - $117,582.40 a year
1 day ago

Qualifications

Collaborate with healthcare professionals
Nursing
Utilization review
Electronic health records (EHR) management
RN License
Patient management software
Utilization management
Associate's degree
Associate Degree in Nursing
Documentation review
Documentation reviews
Nursing

Full Job Description

Working at Moffitt is both a career and a mission: to contribute to the prevention and cure of cancer.

As the only National Cancer Institute-designated Comprehensive Cancer Center based in Florida, Moffitt employs some of the best and brightest minds from around the world. Join a dedicated team of nearly 11,000 who are shaping the future we envision. Moffitt has been recognized as a Best and Brightest Company to Work For in the Nation and is continually named one of the Tampa Bay Times’ Top Workplaces.

Summary

The Utilization Review Nurse is responsible for performing initial, concurrent, and retrospective utilization reviews to determine medical necessity, appropriate level of care, and continued stay in accordance with payer, regulatory, and accreditation requirements. This role supports appropriate resource utilization, denial prevention, and effective appeal outcomes through collaboration with Case Management, Physician Advisors, providers, and payers. The Utilization Review Nurse serves as a clinical resource in utilization management and denial mitigation within the acute care oncology setting.

Job Title: Utilization Review Nurse
Minimum Education Level: Associate's Degree
Minimum Field of Study: Nursing
Minimum Education Notes:
Preferred Education Level: Bachelor's Degree
Preferred Field of Study: Nursing
Preferred Education Notes:
Licensure Certification Needed: Yes
Minimum Licensure: Registered Nurse (RN)
Minimum Licensure (Other):
Training Required: Knowledge of utilization management principles, medical necessity determination, and denial mitigation.Ability to analyze clinical documentation and apply established criteria.Ability to work independently while collaborating effectively with interdisciplinary teams.Organizational skills with attention to detail and deadline management.Proficiency with electronic medical records and standard office software.
Preferred Licensure: Basic Life Support (BLS)Other (If other, please enter details in section to the right)Other (If other, please enter details in section to the right)
Preferred Licensure (Other): CCMACM

Salary Range

$77,022.40 - $117,582.40

Salary ranges posted for this position represent the expected base pay range for the role. Actual compensation may vary based on location and a variety of job-related factors, including experience, skills, education, and internal equity among Team Members in similar positions.

We are committed to maintaining fair and equitable pay practices and regularly review compensation to ensure alignment across our workforce.

Moffitt Career Site

If you have the vision, passion, and dedication to contribute to our mission,

then we have a place for you!

1. Equal Employment Opportunity

Moffitt Cancer Center is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, or protected veteran or disabled status. We seek candidates whose skills, and personal and professional experience, have prepared them to contribute to our commitment to diversity and excellence.

2. Reasonable Accommodation

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment. Moffitt endeavors to make moffitt.org/careers accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact one of the Human Resources receptionists by phone at 813-745-7899 or by email at [email protected]. This contact information is for accommodation requests only and cannot be used to inquire about the status of applications.

Read more information about your EEO rights under the law.

Transparency in Coverage Rule

Apply Now

Refine Your Search

utilization review nurse jobs in oldsmar, fl

RN Utilization Review - Full Time Days

Healthcare Svcs Review Nurse

Care Review Clinician (RN) - Remote in FL

RN Care Manager - FGC Market

MDS Coordinator RN or LPN

Director of Nursing

Registered Nurse Case Manager-Certified

Nurse Case Manager

Care Review Clinician, Specialty Therapist (Occupational / Physical / Speech) - REMOTE from Florida

Clinical Navigator

Utilization Review Specialist Senior

(Part-Time) Legal Nurse Case Reviewer | Orthopaedics / Neurosurgery | Onsite

Care Review Clinician (BH Licensed) - Remote in FL

Onsite Care Coordination Nurse

RN Case Manager PRN Days

Utilization Reviewer 2

Medical Case Manager I

Clinical Nurse Reviewer

Electronic Medical Records Coordinator

Care Manager

I want to receive the latest job alert for utilization review nurse in oldsmar, fl

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Working at Moffitt is both a career and a mission: to contribute to the prevention and cure of cancer.

If you have the vision, passion, and dedication to contribute to our mission,

then we have a place for you!

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