• Care Review Clinician (RN)

    Molina Healthcare (Orlando, FL)
    …Required Qualifications * At least 2 years experience, including experience in hospital acute care , inpatient review, prior authorization, managed care ... for a RN with experience with appeals, claims review, and medical coding . JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment… more
    Molina Healthcare (11/23/25)
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  • Denials Prevention Specialist, Clinician PRN

    Datavant (Tallahassee, FL)
    …BA or BS in Nursing, experience preferred to perform + Minimum Experience: 3 to 5 years acute care experience + 2 years Health Plan or Acute Care ... medical necessity and necessity of continued stay in the inpatient patient care setting and/or discharge to...UR/CM + Preferred Experience: 5 years acute care or health plan UR/CM with 1 year ICU/ER… more
    Datavant (11/12/25)
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  • Physician Asst CT Surgery

    AdventHealth (Ocala, FL)
    …round by contributing specific surgical perspective and promoting integrated comprehensive patient care Inpatient consultation and admission at the direction of ... of AdventHealth with primary focus on clinical services in the inpatient and outpatient setting. Inpatient Responsibilities include: pre-operative admission,… more
    AdventHealth (09/25/25)
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  • Manager Clinical Documentation Improvement Program

    BayCare Health System (Largo, FL)
    …Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of ... of the patient's conditions and precise descriptions of patient care rendered during the hospital inpatient stay....Bachelors:** + 2 years Clinical Documentation & 5 years Acute Care . **Required experience with Masters:** +… more
    BayCare Health System (10/21/25)
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  • Medical Director - OP Claims Mgmt

    Humana (Tallahassee, FL)
    …in care management. The clinical scenarios predominantly arise from outpatient, inpatient or post- acute care environments. Has discussions with external ... post residency or fellowship, which preferably includes some experience in an inpatient /outpatient environment and/or related to care of a Medicare type… more
    Humana (11/24/25)
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  • PCO Medical Director - UM - Part Time (Hourly)

    CenterWell (Tallahassee, FL)
    care facilitation with hospitals. The clinical scenarios predominantly arise from inpatient or post- acute care environments. There are discussions with ... experience post residency or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare type… more
    CenterWell (11/06/25)
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  • Medical Director - Medicaid N. Central

    Humana (Tallahassee, FL)
    …participation in care management. The clinical scenarios arise from outpatient, inpatient or post- acute care environments. The Medical Director will ... experience post residency or fellowship, which preferably includes some experience in an inpatient and/or outpatient environment and/or related to care of a… more
    Humana (10/25/25)
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  • Cardiothoracic Surgery Physician Assistant

    AdventHealth (Tampa, FL)
    …of patient care /safety + Functions fully within the Outpatient and Inpatient setting + Providing on-call coverage for medical triage for outpatients in ... healthcare providers for continued education to ensure comprehensive and coordinated patient care . Provides medical care to patients under the supervision of… more
    AdventHealth (10/04/25)
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  • Coder Analyst III Virtual

    AdventHealth (Tampa, FL)
    …caring for:** AdventHealth Tampa AdventHealth Tampa, a faith-based not-for-profit 626-bed tertiary-level acute care hospital located in the uptown district of ... **The role you'll contribute:** Assigns ICD-10-CM and ICD-10-PCS codes to hospital inpatient accounts utilizing Epic, the 3M Encoder and Dolbey Computer Assisted … more
    AdventHealth (11/12/25)
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  • Physician Asst CT Surgery PRN

    AdventHealth (Ocala, FL)
    …round by contributing specific surgical perspective and promoting integrated comprehensive patient care Inpatient consultation and admission at the direction of ... clinical operation of AdventHealth with primary focus on clinical services in the inpatient and outpatient setting. **The value you'll bring to the team:** PRINCIPAL… more
    AdventHealth (10/06/25)
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