• Pediatric Care Manager (RN)

    Centene Corporation (Miami, FL)
    …is required. **Position Purpose:** Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide high ... needs + Identifies problems/barriers to care and provide appropriate care management interventions + Coordinates as appropriate between the member and/or… more
    Centene Corporation (08/16/25)
    - Related Jobs
  • Quality Improvement CDI Specialist

    NCH (Naples, FL)
    …independent, locally governed non-profit delivering premier comprehensive care. Our healthcare system is comprised of two hospitals, an alliance of 700+ physicians, ... care. NCH is transforming into an Advanced Community Healthcare System (TM) and we're proud to: Provide higher acuity care...mortality for the patient and is reflective of current CMS or other regulatory standards. Will provide other duties… more
    NCH (08/16/25)
    - Related Jobs
  • Senior Care Navigator - Pediatric

    Centene Corporation (Kissimmee, FL)
    …of this position. **License/Certification:** + Current state's clinical license preferred + For CMS Florida licensed practical nurse with a minimum of four years ... with members. **Position Purpose:** Assesses, plans, implements, and coordinates care management activities based on member needs to provide quality, cost-effective… more
    Centene Corporation (08/14/25)
    - Related Jobs
  • PPS Coordinator (RN, PT, OT, SLP) - Inpatient…

    Select Medical (Tallahassee, FL)
    …and personal well-being.** + **Start Strong** : Extensive and thorough Registered Nurse (RN) orientation program to ensure a smooth transition into our setting. ... supporting documentation, and provides staff education to ensure compliance with CMS guidelines. Coordinates all efforts for immediate issue resolution concerning… more
    Select Medical (08/08/25)
    - Related Jobs
  • Quality Improvement Supervisor, Clinical

    CenterWell (Port St. Lucie, FL)
    …analysis of variable factors to solve basic problems; collaborates with management and top professionals/specialists in selection of methods, techniques, and ... the scope of provider relationships across the following areas: + Quality/clinical management and population health + HEDIS and Stars performance + Operational… more
    CenterWell (08/08/25)
    - Related Jobs
  • Program Manager, Clinical Operations & Quality

    ChenMed (Miami, FL)
    …to project teams, sponsors, and executives. + Utilizes problem solving, project management , change management and communication best practices daily to deliver ... + Ensures the infection prevention & control procedures meets CMS , county and state and CDC regulations, standards, or...Healthcare related field preferred + A valid, active Registered Nurse (RN) license in the state of residence required;… more
    ChenMed (08/08/25)
    - Related Jobs
  • SQPE Specialist I

    Cleveland Clinic (Stuart, FL)
    …in educating and evaluating clinical and support department staff regarding quality management regulations and standards of care. + Support medical staff quality ... and facilitate multidisciplinary teams leveraging advanced continuous improvement and project management tools. + Coach smaller improvement teams to success with… more
    Cleveland Clinic (08/08/25)
    - Related Jobs
  • Special Investigation Unit (SIU) Coding Review…

    CVS Health (Tallahassee, FL)
    …of standard industry coding guides and guidelines, including CPT, HCPCS, ICD-10, CMS 1500, and UB04 data elements. + Maintains up-to-date coding knowledge, including ... and the ability to mentor and develop team members. + Registered Nurse (RN). + Previous experience with Behavioral Health coding/auditing of records. **Education:**… more
    CVS Health (08/08/25)
    - Related Jobs
  • RN Care Manager

    AdventHealth (Deland, FL)
    …patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the interdisciplinary team ... core competencies of this role. The RN Care Manager facilitates the collaborative management of patient care across the continuum, intervening to remove barriers to… more
    AdventHealth (08/07/25)
    - Related Jobs
  • Revenue Integrity Clinical Charge Analyst RN

    HCA Healthcare (Ocala, FL)
    …Departments as necessary. + Reviews Regulatory and Compliance Communications, applicable CMS transmittals, and Local Coverage Decisions (LCD). Assess impact to ... reviews and patient audits. **Qualifications that you will need:** + Registered Nurse Degree required. + Minimum 1 year directly related Healthcare experience… more
    HCA Healthcare (08/02/25)
    - Related Jobs