• Monte Nido (Miami, FL)
    …decrease peer to peer reviews. + Communicate emerging trends with insurance companies to Director of Utilization Management . + Maintain database of insurance ... while providing the opportunity for people to realize their healthy selves. ** Utilization Review Clinician** **Monte Nido** **Remote - MST/PST hours** **Monte Nido… more
    DirectEmployers Association (11/04/25)
    - Related Jobs

  • Director of Case Management…

    Select Medical (Lake Worth, FL)
    **Overview** **Critical Illness Recovery Hospital** ** Director of Case Management ** **$10,000 Sign On Bonus** **_Clinical license as a registered nurse or ... doing well by doing what is right. As the Director of Case Management **,**...resource management . + Demonstrating compliance with facility-wide Utilization Management policies and procedures. + Coordinating… more
    Select Medical (11/04/25)
    - Related Jobs

  • Director Case Management

    HCA Healthcare (Okeechobee, FL)
    …**Introduction** Do you want to join an organization that invests in you as a Director Case Management ? At HCA Florida Raulerson Hospital, you come first. ... make a difference. We are looking for a dedicated Director Case Management like you...to ensure continuity of care and optimal clinical resource utilization . The Director has oversight for all… more
    HCA Healthcare (10/22/25)
    - Related Jobs

  • National Accounts Medical Director

    Elevance Health (Miami, FL)
    …members. The medical director provides clinical expertise in all aspects of utilization review and case management . Provides input on the clinical ... clinical responsibilities means that the medical director is directly involved in Utilization Management and Case Management . + Daily case … more
    Elevance Health (09/23/25)
    - Related Jobs

  • Medical Director - Claims Management

    Humana (Tallahassee, FL)
    …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Case managers or Care managers on complex case management , including familiarity with social determinants..., depending on the line of business. The Medical Director conducts Utilization Management or… more
    Humana (11/01/25)
    - Related Jobs

  • Director Care Management

    AdventHealth (Orlando, FL)
    … Management Facility Director reports directly to the Division Care Management Director with a matrix reporting relationship dotted line to the Facility ... Providers and keep the CMOs updated. The Facility Care Management Director communicates regularly with the CFO...above) in addition to 5 years of direct Care Management / Utilization Management experience and increasing… more
    AdventHealth (09/25/25)
    - Related Jobs

  • Manager, Case Management , MD

    Carnival Cruise Line (Miami, FL)
    This role reports to the Senior Manager of Case Management and oversees the daily operations of crew case management . The Manager leads a team of ... guests annually and employing over 160,000 crew members. **Essential Functions:** + Case Management Oversight + Manage high-complexity cases involving clinical… more
    Carnival Cruise Line (08/29/25)
    - Related Jobs

  • Manager, Case Management , RN

    Carnival Cruise Line (Miami, FL)
    This role reports to the Senior Manager of Case Management and oversees the daily operations of crew case management . The Manager leads a team of ... guests annually and employing over 160,000 crew members. **Essential Functions:** + ** Case Management Oversight** + Manage and review cases, including those… more
    Carnival Cruise Line (08/29/25)
    - Related Jobs

  • Medical Director - Medicaid N. Central

    Humana (Tallahassee, FL)
    …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Case managers or Care managers on complex case management , including familiarity with social determinants...Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of… more
    Humana (10/25/25)
    - Related Jobs

  • Medical Director - National UM Team…

    Humana (Tallahassee, FL)
    …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Case managers or Care managers on complex case management , including familiarity with social determinants...size of region or line of business. The Medical Director conducts Utilization Management of… more
    Humana (11/07/25)
    - Related Jobs