• Medical Director - NorthEast Region

    Humana (Tallahassee, FL)
    …insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review organization, ... MD or DO degree + 5+ years of direct clinical patient care experience post residency or...region or line of business. The Medical Director conducts Utilization Management of the care received by… more
    Humana (07/25/25)
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  • Territory Account Manager - 64

    Rep-Lite (Orlando, FL)
    …conditions. You will be responsible for expanding awareness, increasing treatment utilization in established accounts, and building a strong network of referring ... environment and are motivated to make a measurable difference in patient care and business growth. What You'll Do Physician Engagement & Market Development… more
    Rep-Lite (06/13/25)
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  • Assistant Professor, Medicine, General Internal…

    University of Miami (Miami, FL)
    …QI training + Improving patient satisfaction + Improving patient safety + Peer review , performance improvement, utilization review , root cause analysis, and ... with clinical operations leaders and reports updates periodically on the clinical care and support being provided + Provides suggestions to improve… more
    University of Miami (05/24/25)
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  • Manager Case Management

    HCA Healthcare (Gainesville, FL)
    …accordance with the NFRMC Utilization Review Plan and managed care contractual agreements. 1. Submits clinical information to insurance companies to ... ongoing assessment of each individual patient with respect to clinical condition, level of care , and plan...psycho-social, financial). 1. Participates in IDT rounds, 1. Conducts utilization review , evaluates clinical information,… more
    HCA Healthcare (08/02/25)
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  • Public Health Services Manager B - SES

    MyFlorida (Bradenton, FL)
    …ensuring proper coverage, and complete timesheets The incumbent serves as the Clinical Services Division Deputy Director, responsible for supporting and reporting on ... The incumbent is also responsible for the administrative daily operations of the Clinical Services Division. Serves as back-up to the Clinical Services Division… more
    MyFlorida (08/08/25)
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  • Sr. Manager, Financial Counseling

    University of Miami (Miami, FL)
    …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The ... work in Miami. The Senior Manager, Financial Counseling coordinates financial and clinical provider teams and services. This role procures, designs, negotiates, and… more
    University of Miami (07/29/25)
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  • Director of Case Management ( RN / RT / MSW / LPN…

    Select Medical (Gainesville, FL)
    …and professional growth of the department, including, but not limited to: Utilization Review (UR) and resource management, discharge planning, treatment plan ... ) experience with medically complex patients in a hospital critical care setting and supervisory experience.** At Select Specialty/Regency Hospitals, a division… more
    Select Medical (08/02/25)
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  • Organ Allocation Coordinator 2 (H)

    University of Miami (Miami, FL)
    …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The ... The OAC is responsible for all activities related to the allocation and utilization of organs from donors. Including, organ allocation for transplant and research,… more
    University of Miami (08/01/25)
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  • Physician (Psychiatry) - Mental Health Clinic…

    Veterans Affairs, Veterans Health Administration (Lake City, FL)
    …compliance with the credentialing and privileging processes, monitoring and evaluation of clinical practice, peer review , and other appropriate quality assurance ... care are continuously evaluated and improved: Access, Quality of Care , Customer Service/Patient Satisfaction, and Utilization Management/Efficiency of … more
    Veterans Affairs, Veterans Health Administration (08/14/25)
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  • RN Case Manager PRN

    HCA Healthcare (Gainesville, FL)
    …interdisciplinary plan of care with a focus on evaluating the appropriateness of clinical care , medical necessity, admission status, level of care , and ... and patient throughput while supporting a balance of optimal care and appropriate resource utilization . You would...is preferred + Certification in Case Management, Nursing or Utilization Review is preferred HCA Florida North… more
    HCA Healthcare (06/21/25)
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