• CMO UChicago Medicine & AdventHealth…

    AdventHealth (Altamonte Springs, FL)
    …as a clinical leader to the hospitals medical staff providing guidance in case management, appropriate levels of care for patients, efficient utilization of ... medical staff members and lower cost. Direct reports include + Med Staff Manager **PRINCIPAL DUTIES AND JOB RESPONSIBILITIES** **:** + Leads in the continuing… more
    AdventHealth (09/09/25)
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  • Medical Management Specialist I

    Elevance Health (Tampa, FL)
    …would provide an equivalent background. **Preferred Qualifications:** + Understanding of managed care or Medicaid/Medicare strongly preferred. + Fully Bilingual ... are not limited to: + Gathers clinical information regarding case and determines appropriate area to refer or assign...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (09/06/25)
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  • CM Delegation Liaison

    Molina Healthcare (St. Petersburg, FL)
    …in care management, utilization management, behavioral health, medical, and/or managed care setting, or equivalent combination of relevant education and ... and organizational skills. * Strong interpersonal skills. **PREFERRED QUALIFICATIONS:** * Certified Case Manager (CCM). To all current Molina employees: If you… more
    Molina Healthcare (09/05/25)
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  • Quality Improvement RN

    CenterWell (Tampa, FL)
    …Qualification** + Bachelor's Degree in Nursing + 3+ years of managed care experience + 3+ years of case management experience + Bilingual; English ... responsible for the development, implementation and management oversight of the Primary Care Organization's Stars Program in the North Florida market. The Stars… more
    CenterWell (08/13/25)
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  • Quality Improvement RN

    CenterWell (New Smyrna Beach, FL)
    …Qualification** + Bachelor's Degree in Nursing + 3+ years of managed care experience + 3+ years of case management experienceBilingual; English and Spanish ... life insurance and many other opportunities. **About Us** About Conviva Senior Primary Care : Conviva Senior Primary Care provides proactive, preventive care more
    CenterWell (08/12/25)
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  • Clinical Appeals Nurse (RN)

    Molina Healthcare (Tampa, FL)
    …preferred. **Required Experience** + 3-5 years clinical nursing experience, with 1-3 years Managed Care Experience in the specific programs supported by the plan ... of service provided, length of stay and level of care . + Applies appropriate criteria on PAR and Non-PAR...Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management… more
    Molina Healthcare (08/15/25)
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