• RN Registered Nurse Utilization Management

    AdventHealth (Tampa, FL)
    …for each position may vary based on geographical location. **Category:** Case Management **Organization:** AdventHealth Tampa **Schedule:** Full-time **Shift:** ... the Utilization Management (UM) Registered Nurse (RN) is to use clinical expertise by analyzing patient records to determine legitimacy of hospital admission,… more
    AdventHealth (09/05/25)
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  • Director of Quality Management - Inpatient…

    Select Medical (Miami, FL)
    …Miami, FL** **$10,000 Sign-on Bonus** **Director of Quality Management ** **(DQM)** **Responsibilities** **Position Summary** Coordinates the Medical Quality ... Management and Performance Improvement activities to measurably enhance the...and compliance of quality processes/activities in the areas of clinical /medical staff PI for all applicable clinical /medical… more
    Select Medical (06/20/25)
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  • Chief Medical Officer

    HCA Healthcare (Port St. Lucie, FL)
    …Offers clinical support for appeals and denials process, discharge planning, case management , and utilization review/ management . + Consults with ... Provides clinical support and consultation regarding cost-effective clinical resource management in the facilities by...the denial and appeals process, as requested by the Case Management Department and Patient Accounting Services.… more
    HCA Healthcare (08/26/25)
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  • Care Management Social Work Part Time

    AdventHealth (New Smyrna Beach, FL)
    …for each position may vary based on geographical location. **Category:** Case Management **Organization:** AdventHealth New Smyrna Beach **Schedule:** Part-time ... ensures efficient and cost-effective care through appropriate resources monitoring, and clinical care escalations. The Social Work Specialist is under the general… more
    AdventHealth (08/19/25)
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  • Director of Care Management FT Days

    AdventHealth (Minneola, FL)
    …each position may vary based on geographical location. **Category:** Case Management **Organization:** AdventHealth Minneola **Schedule:** Full-time **Shift:** ... critical care and general medical/surgical rooms. We are proud to be delivering clinical solutions for the mind, body and spirit in the Minneola community. **The… more
    AdventHealth (08/23/25)
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  • Manager Care Management

    AdventHealth (Orlando, FL)
    …each position may vary based on geographical location. **Category:** Case Management **Organization:** AdventHealth Orlando **Schedule:** Full-time **Shift:** ... Education (Certifications and Degrees without out-of-pocket tuition expense) + Nursing Clinical Ladder Program **Our promise to you:** Joining AdventHealth is about… more
    AdventHealth (08/07/25)
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  • RN Registered Nurse Care Management

    AdventHealth (Port Charlotte, FL)
    …for each position may vary based on geographical location. **Category:** Case Management **Organization:** AdventHealth Port Charlotte **Schedule:** Full-time ... Manager ensures efficient and cost-effective care through appropriate resources monitoring, and clinical care escalations. The RN Care Manager is under the general… more
    AdventHealth (08/07/25)
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  • Director, Prospective + Concurrent Risk Adjustment…

    Datavant (Tallahassee, FL)
    …of service. This is a leadership role that combines strategic thinking, clinical product development expertise, and people management responsibilities. You'll be ... grow. **Key Qualifications** **Required** + 8+ years of product management experience in healthcare, including ownership of clinical...reviewed by Datavant Human Resources and determined on a case -by- case basis. Depending on the state in… more
    Datavant (08/08/25)
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  • Assistant Vice President

    Sedgwick (Tallahassee, FL)
    …equivalent combination of education and experience required to include five (5) years medical case management , two (2) years clinical experience, two (2) ... client satisfaction; to ensure efficient, cost effective, and high quality delivery of case management and utilization review services to clients for multiple… more
    Sedgwick (09/05/25)
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  • Medical Director - Care Plus - Florida

    Humana (Tallahassee, FL)
    …prior experience participating in teams focusing on quality management , utilization management , case management , discharge planning and/or home health or ... + Experience working with Case managers or Care managers on complex case management , including familiarity with social determinants of health. + The… more
    Humana (09/04/25)
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