• Regional Team Leader, Specifications

    CDM Smith (West Palm Beach, FL)
    …our Specifications Group. We're looking for candidates with experience as a Senior Manager and Senior Specification Writer. At CDM Smith, we are invested in your ... of your team. - Coordinating workload within your Technical Services group and utilization goals for the individuals on your team. - Coordinating with your TDM… more
    CDM Smith (08/01/25)
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  • Registered Nurse RN Home Health

    AdventHealth (Deland, FL)
    …in a Medicare-certified home health agency as a visit nurse + Home Health Case Manager Certification + COS-C This facility is an equal opportunity employer ... the home care patients care based on individual patient needs. The RN Care Manager is responsible for independent management of the Home Health patient… more
    AdventHealth (09/28/25)
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  • Infusion Referral Nurse Sr- REMOTE

    Prime Therapeutics (Tallahassee, FL)
    …of post-degree clinical experience. + Experience in managed care, specialty drugs, care management and utilization review. + Meets Credentialing criteria. + At ... for drug services. + Will actively maintain a required case load and the activities to reach overall goals...appeals program. + Participates in meetings and consults with management on regular basis to discuss member interaction and… more
    Prime Therapeutics (09/04/25)
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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 (07/25/25)
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  • LVN Delegation Oversight Nurse Remote

    Molina Healthcare (St. Petersburg, 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 (09/20/25)
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  • Program Administrator - SES

    MyFlorida (Jacksonville, FL)
    …is responsible for assurance of family planning program linkages to both DOH clinical/ case management as well as community services. The Administrator provides ... supervises staff who provide family planning care coordination and case management activities to ensure DOH patients...Start on Family Planning. Acts as the lead contract manager for the sterilization grants and provides monitoring of… more
    MyFlorida (09/24/25)
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  • Nurse Practitioner, Cardiology

    ChenMed (Orlando, 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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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Tampa, FL)
    …Clinical Coder, Certified Medical Audit Specialists, Certified Case Manager , Certified Professional Healthcare Management , Certified Professional in ... of payment decisions. + Serves as a clinical resource for Utilization Management , Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals.… more
    Molina Healthcare (09/06/25)
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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 (08/22/25)
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  • Transitions of Care - RN, 100% Virtual, CareBridge

    Elevance Health (FL)
    …patients with IDD and patients with special needs is preferred. + Home Health, Utilization Management or Case Management experience strongly preferred. ... community agencies and appropriate provider/network. + Refers member to catastrophic case management . **Minimum Requirements:** Requires AS in nursing and… more
    Elevance Health (10/01/25)
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