• Transplant Nurse II (US)

    Elevance Health (Miami, FL)
    …on the team in preparation for advancement to the senior level. Within the case management role will within the scope of licensure assess, develop, implement ... The **Transplant Nurse II** will be responsible for providing case and/or medical management for members receiving...claims or service issues. + Assists with development of utilization /care management policies and procedures. + Within… more
    Elevance Health (11/22/25)
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  • Med Mgmt Nurse (US)

    Elevance Health (Tampa, FL)
    …critical thinking skills and nursing judgment and experience. + Collaborates with case management nurses on discharge planning, ensuring patient has appropriate ... about plan benefits and physicians and may assist with case management . + Collaborates with leadership in...experience and requires a minimum of 2 years clinical, utilization review, or managed care experience; or any combination… more
    Elevance Health (11/19/25)
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  • Senior Information Security Engineer…

    Lumen (Tallahassee, FL)
    …and track improvements in technologies and processes. + Analyze system utilization statistics to identify performance bottlenecks and recommend enhancements for ... update, and adhere to corporate and team-level processes, including change and outage management protocols. **What We Look For in a Candidate** + Bachelor's degree… more
    Lumen (11/15/25)
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  • Managed Care Pharmacy Resident

    Elevance Health (Tampa, FL)
    …care management process through reviewing member profiles, recommending members for lock-in, case management or disease management . + Respond to and ... of the CarelonRx pharmacy program, including Prior Authorizations, Medication Therapy Management (MTM), Lock-in, and Drug Utilization Review (DUR) programs.… more
    Elevance Health (10/20/25)
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  • Project Engineer

    Baker Construction (Fort Lauderdale, FL)
    …in establishing clinics, managing first report of injuries, and assisting with co-worker case management + Follows Company Recruitment and Hiring Guidelines + ... and other reports + Alerts the Superintendent and Project Manager of project impact relating to resource management...utilization , MBE/SBE participation, etc., and advises the Project Manager of issues + Interfaces with Safety and Risk… more
    Baker Construction (11/15/25)
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  • Behavioral Health Medical Director-Psychiatrist…

    Elevance Health (Tampa, FL)
    …Capabilities and Experiences:** + Child and Adolescent experience preferred. + Utilization Management experience. + Applied Behavior Analysis (ABA) experience. ... clinical operational aspects of a program. + Conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss… more
    Elevance Health (11/19/25)
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  • Area Arch Specialist

    Terumo Aortic (Sunrise, FL)
    …+ Creates account specific strategies by geography to drive market acceptance and utilization of Thoracic devices. + Assists with new implanters of Thoracic devices, ... namely Thoraflex, to include in-servicing and initial case support. + Maintains a network of ...strategy in conjunction with Clinical Marketing, Downstream Marketing, and Manager of Medical Education + Actively involved in sales… more
    Terumo Aortic (10/24/25)
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  • LVN Delegation Oversight Nurse Remote

    Molina Healthcare (Tampa, FL)
    …Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM) or Certified ... reports submitted to the Eastern US Quality Improvement Collaborative (EQIC) and/or utilization management committees. + Participates as needed in joint… more
    Molina Healthcare (11/13/25)
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  • Nurse Practitioner, Cardiology

    ChenMed (Hollywood, FL)
    …development of the nursing plan of care, health education, physician referrals, case management referrals, follow-up and clear documentation according to ChenMed ... guidelines. This position may require participation in risk and quality management programs, clinical meetings and other meetings. The Nurse Practitioner, Specialty… more
    ChenMed (09/26/25)
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  • Home Care Supervisor, RN

    BayCare Health System (Bradenton, FL)
    …the Emergency Management program for office and agency staff. + Participates with Case Manager on initial Plan of Care review with a focus on quality, ... bodies within the area of responsibility. + Ensure quality assurance program and utilization review is followed in accordance with Home Care protocol. + Oversees and… more
    BayCare Health System (11/20/25)
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