• Medical Director - IP Claims…

    Humana (Tallahassee, FL)
    …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement...with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (12/11/25)
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  • Medical Director - Medicaid N. Central

    Humana (Tallahassee, FL)
    …to the Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (10/25/25)
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  • Medical Director - Medicaid (remote)

    Humana (Tallahassee, FL)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (12/07/25)
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  • PCO Medical Director - UM - Part Time…

    CenterWell (Tallahassee, FL)
    …**Additional Information** Will report to the Director of Physician Strategy at Utilization Management . The Medical Director conducts Utilization ... a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health claims. The Medical … more
    CenterWell (11/06/25)
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  • Senior Medical Director

    Molina Healthcare (Miami, FL)
    …years as a medical director in managed care setting supporting utilization management /quality management initiatives, or equivalent combination of ... of prior authorization, inpatient concurrent review, discharge planning, care management and interdisciplinary care team (ICT) activities. * Recruits, hires,… more
    Molina Healthcare (12/07/25)
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  • Utilization Review RN

    Community Health Systems (Naples, FL)
    Join us as a **Registered Nurse (RN) - Utilization Review position** at Physicians Regional Collier Unit: Utilization Review Shift: Mon-Fri (this is an onsite ... match & more available for Full and Part-Time roles **Job Summary** The Utilization Review Nurse - RN reviews hospital admissions, extended stays, and supporting… more
    Community Health Systems (11/20/25)
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  • Field Medical Director , Pain…

    Evolent (Tallahassee, FL)
    …Clinical Reviewer, Interventional Pain Management , you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... + On a requested basis, may function as Medical Director for selecting health plans or regions, assuming overall...selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with… more
    Evolent (11/19/25)
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  • Director of Case Management Sign…

    Select Medical (Gainesville, FL)
    …focus on resource management . + Demonstrating compliance with facility-wide Utilization Management policies and procedures. + Coordinating UR compliance with ... **Overview** **Select Specialty Hospital** **Critical Illness Recovery Hospital (LTACH)** ** Director of Case Management ** **$10,000 Sign On Bonus** **Full Time:… more
    Select Medical (12/09/25)
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  • Director of Case Management ( RN…

    Select Medical (Lake Worth, FL)
    …focus on resource management . + Demonstrating compliance with facility-wide Utilization Management policies and procedures. + Coordinating UR compliance with ... **Overview** **Critical Illness Recovery Hospital** ** Director of Case Management ** **$10,000 Sign...growth of the department, including, but not limited to: Utilization Review (UR) and resource management , discharge… more
    Select Medical (11/04/25)
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  • Director Case Management

    HCA Healthcare (Atlantis, FL)
    …charitable organizations. Apply Today! **Job Summary and Qualifications** The Facility Case Management Director has the overall responsibility for managing and ... We care like family! Jump-start your career as a Director Case Management today with HCA Florida...to ensure continuity of care and optimal clinical resource utilization . The Director has oversight for all… more
    HCA Healthcare (12/14/25)
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