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Utilization Management Associate Jobs in Brandon, FL

GiaCare

Registered Nurse - Case Manager

Tampa, FL · On-site

Collaborate with providers, utilization management, and behavioral health staff on shared cases ... Associate's Degree of Nursing * Current, full, active, unrestricted Registered Nurse license in any ...

Moffitt Cancer Center

RN Case Manager PRN Days

Tampa, FL · On-site

$44.25/hr

... utilization management. This role may require weekend and holiday work coverage rotation. Minimum Education Level: Associate's Degree Minimum Field of Study: Nursing Preferred Education Level:

SPEROS

RN Case Manager PRN Days

Tampa, FL · On-site

$44.25/hr

... utilization management. This role may require weekend and holiday work coverage rotation.**Job Title:** Case Manager PRN **Minimum Education Level:** Associate's Degree **Minimum Field of Study:

Marten Transport

Account Manager- Dry

Tampa, FL · On-site

Account Manager will provide leadership and direction to Account Manager Associate to ensure the ... utilization and service expectations. 5. Communicate any problems encountered to the Regional Sales ...

Marten Transport

Account Manager- Dry

Tampa, FL · On-site

Account Manager will provide leadership and direction to Account Manager Associate to ensure the ... utilization and service expectations. 5. Communicate any problems encountered to the Regional Sales ...

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All JobsUtilization Management Associate JobsUtilization Management Associate Jobs in Brandon, FL

Utilization Management Associate information

What does a utilization management associate do?

A Utilization Management Associate is responsible for reviewing healthcare services and determining whether they are medically necessary, appropriate, and efficient. They work with healthcare providers, insurance companies, and patients to ensure that treatments comply with established guidelines and policies. Their role often includes reviewing medical records, processing authorizations, and assisting in the coordination of care to optimize the use of healthcare resources. This position helps control costs while ensuring that patients receive the appropriate level of care.

What skills and qualifications are needed to thrive as a utilization management associate?

A Utilization Management Associate typically needs a background in healthcare administration or a related field, strong analytical skills, and knowledge of medical terminology and insurance guidelines. Familiarity with utilization review software, electronic health records (EHRs), and regulatory compliance systems is important, and certifications like Certified Professional in Healthcare Management (CPHM) can be advantageous. Attention to detail, effective communication, and strong organizational skills help associates excel in evaluating medical necessity and collaborating with care teams. These competencies ensure accurate, efficient review processes that support quality patient care and compliance with payer requirements.

What are the typical daily responsibilities of a utilization management associate?

Utilization Management Associates typically review medical records, verify insurance coverage, and coordinate with healthcare providers to ensure that treatments and services meet established guidelines and payer requirements. They also communicate with physicians and patients to gather necessary information for authorization requests. By ensuring appropriate utilization of healthcare resources, they help support patient care while managing costs and compliance for their organization. Collaboration with clinical staff and insurance representatives is a key part of the role, contributing to effective case management.

What is the difference between Utilization Management Associate vs Utilization Review Coordinator?

AspectUtilization Management AssociateUtilization Review Coordinator
CertificationsTypically requires a healthcare-related certification or licenseOften requires similar certifications, such as CCM or RHIA
Work EnvironmentWorks in insurance companies, healthcare providers, or managed care organizationsWorks in hospitals, insurance companies, or healthcare facilities
Job FocusAssists in reviewing medical necessity and authorization processesCoordinates and conducts utilization reviews and approvals
Common UsageUsed interchangeably in healthcare and insurance settingsOften used in hospital and insurance contexts

The Utilization Management Associate and Utilization Review Coordinator roles share similarities in certifications and work environments, focusing on reviewing medical necessity and authorization. The main difference lies in their specific responsibilities, with associates assisting in the process and coordinators actively conducting reviews and approvals.

What are the most commonly searched types of Utilization Management jobs in Brandon, FL?

The most popular types of Utilization Management jobs in Brandon, FL are:

What cities near Brandon, FL are hiring for Utilization Management Associate jobs?

Cities near Brandon, FL with the most Utilization Management Associate job openings:

Infographic showing various Utilization Management Associate job openings in Brandon, FL as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution.

Registered Nurse - Case Manager

Tampa, FL • On-site

GiaCare
Recruiting and Staffing Services • 51 - 200 employees
Learn more about GiaCareexternal

Other

This job post has expired 2 days ago. Applications are no longer accepted.

Job description

Case Manager Rn Opportunity At Macdill Air Force Base

GiaCare Inc. is accepting applications from experienced Case Managers (RN) for a future opportunity supporting MacDill Air Force Base at Tampa, Florida.

This position is being recruited in anticipation of contract award. Qualified candidates will be considered for employment upon contract award.

About The Opportunity

Join a collaborative care team as a Case Manager RN, coordinating care transitions and complex-case management for active-duty service members, retirees, and their families across the 6 MDG system of care.

Schedule
  • Full-Time
  • Monday–Friday
  • 9-hour shifts, duty hours 0730–1630
  • 60-minute unpaid lunch
  • Not to exceed 40 hours per week
  • No on-call
Responsibilities
  • Assess, plan, implement, and coordinate individualized case management plans for patients with complex medical or psychosocial needs
  • Coordinate care transitions, referrals, and discharge planning across the interdisciplinary care team
  • Identify and connect patients with appropriate community and military health system resources
  • Monitor high-risk and complex patients to support continuity of care and reduce avoidable utilization
  • Collaborate with providers, utilization management, and behavioral health staff on shared cases
  • Document case management activity accurately within the electronic medical record
Minimum Qualifications
  • U.S. Citizen, U.S. national, lawful permanent resident, or individual otherwise authorized to work in the United States
  • Associate's Degree of Nursing
  • Current, full, active, unrestricted Registered Nurse license in any U.S. state, territory, or the District of Columbia
  • Prior clinical nursing experience; case management experience strongly preferred
  • Current Basic Life Support (BLS) certification (or willing to obtain)
  • Able to pass a Tier 1 (or higher) background investigation for facility and network access
  • 3 years in last 4 years as RN case manager, plus one of 8 named case-management certifications
Preferred Qualifications
  • Certified Case Manager (CCM) credential or equivalent
  • Experience in case management within a military treatment facility or TRICARE-network setting
  • Strong care coordination, documentation, and interdisciplinary communication skills
Why GiaCare?

GiaCare is dedicated to supporting our nation's military by connecting exceptional healthcare professionals with military treatment facilities throughout the United States. Our team is committed to delivering high-quality patient care while providing meaningful career opportunities for healthcare professionals.

This position is being recruited in anticipation of contract award. Employment is contingent upon contract award and successful completion of all pre-employment requirements.

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