• PCO Medical Director - UM - Part Time (Hourly)

    CenterWell (Tallahassee, FL)
    …prior experienceparticipatingin teams focusing on transitions of care, quality management ,utilizationmanagement, case management , discharge planning and/or ... of business metrics. + Experience working with Casemanagersor Caremanagerson complex case management , including familiarity with social determinants of health.… more
    CenterWell (11/06/25)
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  • Registered Nurse RN Home Health

    AdventHealth (Deland, FL)
    **RN Case Manager | AdventHealth Home Health** **All the benefits and perks you need for you and your family:** Up to $5,000 Sign on Bonus Benefits from Day One ... care based on individual patient needs. The RN Care Manager is responsible for independent management of...experience in a Medicare-certified home health agency as a case - manager o Bachelors degree in nursing o… more
    AdventHealth (11/18/25)
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  • RN UM Clinical Appeals Nurse Remote

    Molina Healthcare (Orlando, FL)
    …(CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified Professional ... chief medical officer on denial decisions. * Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. *… more
    Molina Healthcare (11/14/25)
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  • Cardiology Medical Director

    Elevance Health (FL)
    …mandated policies, and CMS Coverage Determinations, as applicable. + Perform physician-level case review of utilization requests for procedures and interventions ... proud member of the Elevance Health family of companies, Carelon Medical Benefits Management , formerly AIM Specialty Health, is a benefit- management leader in… more
    Elevance Health (11/12/25)
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  • Program Director

    Sevita (Jacksonville, FL)
    …care, advocacy, stakeholder relations, regulatory compliance, staffing, training, financial management , and maintenance of the physical environment. **ESSENTIAL JOB ... be able to satisfactorily perform each essential function listed below._ **Staff Management :** 1. Recruitment & Hiring: May participate in hiring events as needed… more
    Sevita (11/19/25)
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  • Field Clinical Specialist, Tampa - Transcatheter…

    Edwards Lifesciences (Tampa, FL)
    …**How you will make an impact:** + Working independently in the areas of valve crimping, case management , pre- case planning, post- case management , 3 ... Mensio management , Therapy Awareness program management and clinical education programs. + Implementing sales and...educational material during training sessions in order to drive utilization of the Edwards's THV product portfolio. + Utilizing… more
    Edwards Lifesciences (11/14/25)
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  • Occupational Therapist OT Home Health

    AdventHealth (Palm Coast, FL)
    …. Recent, relevant experience in a Medicare-certified home health agency as a case - manager . Certified Case Manager . Certificate for OASIS Specialist - ... the home care patient's services based on individual patient needs. The OT Care Manager is responsible for independent management of the Home Health patient… more
    AdventHealth (11/20/25)
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  • Physical Therapist PT Home Health

    AdventHealth (Winter Haven, FL)
    …the home care patient's services based on individual patient needs. The PT Care Manager is responsible for independent management of the Home Health patient ... + Recent, relevant experience in a Medicare-certified home health agency as a case - manager + Certificate for OASIS Specialist - Clinical + Home Health… more
    AdventHealth (10/03/25)
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  • Social Work Specialist

    AdventHealth (New Smyrna Beach, FL)
    …for each position may vary based on geographical location. **Category:** Case Management **Organization:** AdventHealth New Smyrna Beach **Schedule:** Full-time ... Specialist is under the general supervision of the Care Management Supervisor or Manager and is responsible...physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge… more
    AdventHealth (11/20/25)
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  • Associate Medical Director

    CenterWell (Jacksonville, FL)
    …our primary care team, combining clinical practice with leadership and operational management to ensure high-quality patient care and alignment with Value-Based Care ... adapt responsibilities as needed and demands a unique blend of clinical management , financial/business acumen, and strategic partnership to optimize patient care and… more
    CenterWell (11/21/25)
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