• Medical Director- South Central

    Humana (Tallahassee, FL)
    …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Utilization management experience in a medical management review organization, such as Medicare Advantage,... Case managers or Care managers on complex case management , including familiarity with social determinants… more
    Humana (07/11/25)
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  • Director of Quality Management - Inpatient…

    Select Medical (Miami, FL)
    …documentation related to the hospital's CQI program. + Performs basic chart review activities with appropriate staff for outcome utilization , infection control ... **Location: Miami, FL** **$10,000 Sign-on Bonus** **Director of Quality Management ** **(DQM)** **Responsibilities** **Position Summary** Coordinates the Medical Quality… more
    Select Medical (06/20/25)
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  • Medical Director - NorthEast Region

    Humana (Tallahassee, FL)
    …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Utilization management experience in a medical management review organization, such as Medicare Advantage,... Case managers or Care managers on complex case management , including familiarity with social determinants… more
    Humana (07/25/25)
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  • RN Registered Nurse Care Management

    AdventHealth (Port Charlotte, FL)
    …for each position may vary based on geographical location. **Category:** Case Management **Organization:** AdventHealth Port Charlotte **Schedule:** Full-time ... patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the interdisciplinary team… more
    AdventHealth (08/07/25)
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  • Behavioral Health Medical Director - Medicare

    Humana (Tallahassee, FL)
    …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Utilization management experience in a medical management review organization, such as Medicare Advantage... Case managers or Care managers on complex case management , including familiarity with social determinants… more
    Humana (08/09/25)
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  • RN Care Management

    AdventHealth (Riverview, FL)
    …each position may vary based on geographical location. **Category:** Case Management **Organization:** AdventHealth Riverview **Schedule:** Full-time **Shift:** ... patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the interdisciplinary team… more
    AdventHealth (08/07/25)
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  • Medical Director, Clinical Services

    Highmark Health (Tallahassee, FL)
    …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review , the incumbent participates as the...need. **Preferred** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral… more
    Highmark Health (07/29/25)
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  • Sr. Manager, Financial Counseling

    University of Miami (Miami, FL)
    …and utilization of data used by all levels of management within the organization.5. Interacts, communicates, and intervenes with multidisciplinary healthcare ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Department of… more
    University of Miami (07/29/25)
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  • Vice President, Strategic Accounts

    Datavant (Tallahassee, FL)
    …###@datavant.com . We will review your request for reasonable accommodation on a case -by- case basis. For more information about how we collect and use your ... benchmarking, goal setting, timely execution, and superior leadership. + Strong utilization of SalesForce to include monitoring and documenting member information. +… more
    Datavant (07/03/25)
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  • Child and Family Services Specialist - Circuit 18…

    Community Based Care of Brevard, Inc. (Rockledge, FL)
    …in a solution focused manner. The Child and Family Services Specialist enters case activity into FSFN, is clinically astute, offers consultation to CPI's, attends ... "close the loop". This position produces necessary reports on utilization in a culturally competent, flexible and responsive service...of families referred for services by DCF that includes review and discussion of family situation and risk level,… more
    Community Based Care of Brevard, Inc. (07/30/25)
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