• Director, Appeals & Grievances ( Medicare )

    Molina Healthcare (St. Petersburg, FL)
    …UM, Case Management, Claims, and other departments within Molina Medicare and Medicaid regarding A&G operations and dependencies. * Responsible for the ... appeals and grievance processing/resolution, including 3 years in a manager role. * Experience with Medicare Regulations,...in a manager role. * Experience with Medicare Regulations, Medicare Duals, Appeals & Grievances,… more
    Molina Healthcare (07/20/25)
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  • Lead Case Manager

    HCA Healthcare (Ocala, FL)
    …purpose and integrity. We care like family! Jump-start your career as a(an) Lead Case Manager today with HCA Florida Ocala Hospital. **Benefits** HCA Florida ... by location._** Come join our team as a Lead Case Manager . We care for our community!...continued stay and discharge criteria. Orientation will also include Medicare and insurance benefits, grievance procedures, treatment plan process,… more
    HCA Healthcare (07/13/25)
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  • Case Manager , Registered Nurse

    CVS Health (Tallahassee, FL)
    …it all with heart, each and every day. **Position Summary** Community Care Case Manager (CM) use a collaborative process of assessment, planning, facilitation, ... navigating multiple systems and keyboarding - Compact RN licensure - Certified Case Manager - Additional national professional certification (CRC, CDMS, CRRN,… more
    CVS Health (07/31/25)
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  • Case Manager (Neuro)

    Sevita (Sarasota, FL)
    …and specialized services for infants, children, adolescents, Military Service Members and Veterans. ** Case Manager - TBI - Residential Group Homes** The Case ... and implement services to meet an individual's needs. + Provide case management services including intake, assessment, crisis intervention, advocacy, referral, and… more
    Sevita (07/10/25)
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  • Case Manager - UM II -100%

    Healthfirst (FL)
    The Case Manager , Utilization Management coordinates the care plan for assigned members and conducts pre-certification, concurrent review, discharge planning, ... and case management as assigned. The Case Manager , Utilization Management is also responsible...Interqual and/or Milliman knowledge + Knowledge of Centers for Medicare & Medicaid Services (CMS) or New York State… more
    Healthfirst (08/08/25)
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  • Child Case Manager

    WestCare Foundation (Key West, FL)
    Child Case Manager Job Details Job Location Key West - 1205 4th - Key West, FL Position Type Full Time Education Level 4 Year Degree Salary Range $21.22 - $21.22 ... Hourly Job Category Nonprofit - Social Services Description Position Summary: Provide case management service to clients as outlined in the case management… more
    WestCare Foundation (07/24/25)
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  • Case Manager - Registered Nurse

    CVS Health (Tallahassee, FL)
    …organizational, and interpersonal skills + Ability to work independently + Certified Case Manager + National professional certification (CRC, CDMS, CRRN, COHN, ... post-acute care, hospice, palliative care, cardiac, home health with Medicare members + 2+ years case management,...health with Medicare members + 2+ years case management, discharge planning and/or home health care coordination… more
    CVS Health (07/31/25)
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  • Registered Nurse Case Manager

    AdventHealth (Wauchula, FL)
    …+ Recent, relevant experience in a Medicare -certified home health agency as a case - manager + Home Health Case - Manager Certification + Certificate for ... **Registered Nurse Case Manager - AdventHealth Home Health** **All the benefits and perks you need for you and your family:** + Up to $10,000 Sign on Bonus +… more
    AdventHealth (08/07/25)
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  • Assistant Nurse Manager - Case

    Cleveland Clinic (Stuart, FL)
    …* Current state FL licensure as Registered Nurse (RN). * Professional certification as a Case Manager (CCM) * 3 years or more of acute care nursing experience ... patients stay on track with their health goals. As an Assistant Nurse Manager in Care Management, you will assist with day-to-day operations, utilize clinical… more
    Cleveland Clinic (07/10/25)
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  • Case Management Assistant

    HCA Healthcare (Fort Walton Beach, FL)
    case management assistant (CMA) will work under the direction of the RN case manager or social worker to assist with facilitating patient discharges requiring ... will do in this role: + Coordinates with RN case manager and social worker for support...including having the Patient Choice letter signed. + Monitors Medicare patient's planned discharge dates and delivers the Important… more
    HCA Healthcare (08/08/25)
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