- Molina Healthcare (Tampa, FL)
- …unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management + Certified ... For this position we are seeking a (RN) Registered Nurse who must be licensed for the state they...Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. +… more
- ChenMed (Plantation, FL)
- …We're rapidly expanding and we need great people to join our team. The Nurse Practitioner (NP) acts as part of the clinical operations team and is responsible ... of the nursing plan of care, health education, physician referrals, case management referrals, follow-up and clear documentation according to ChenMed standards… more
- Prime Therapeutics (Tallahassee, FL)
- …drives every decision we make. **Job Posting Title** Infusion Referral Nurse - REMOTE **Job Description** Under supervision, is responsible for performing referral ... for drug services. + Will actively maintain a required case load and the activities to reach overall goals...Quality oversight for this program is provided by the Manager , Patient Programs. **Education & Experience** + Associates -… more
- MyFlorida (Bradenton, FL)
- …administration, special procedures, etc. according to state and local guidelines; acts as case manager for students with special acute and chronic conditions, ... SENIOR COMMUNITY HEALTH NURSE - 64080249 Date: Aug 8, 2025 The...of their job duties. Knowledge, skills, and abilities, including utilization of equipment, required for the position: + Knowledge… more
- AdventHealth (Port Charlotte, FL)
- …in Charlotte County. **The role you'll contribute** **:** The RN Care Manager in collaboration with the patient/family, social workers, nurses, physicians and the ... and progression through the continuum of care. The RN Care Manager ensures efficient and cost-effective care through appropriate resources monitoring, and… more
- CVS Health (Tallahassee, FL)
- …hours, as needed. This position reports to the Potential Quality of Care (PQOC) nurse investigator team manager . This position is responsible for the review and ... Qualifications** - Emergency/critical care experience - Experience working Grievance cases - Case Management or Utilization Management experience - Managed care… more
- Molina Healthcare (St. Petersburg, FL)
- …ASSOCIATION:** Certified Clinical Coder, Certified Medical Audit Specialists, Certified Case Manager , Certified Professional Healthcare Management, Certified ... of payment decisions. + Serves as a clinical resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. +… more
- CenterWell (Deland, FL)
- …Deland, FL **This position comes with a $10K sign-on bonus.** The **Clinical Manager ** coordinates and oversees all direct care patient services provided by clinical ... the delivery of care to all patients served by the location. Receives case referrals. Reviews available patient information related to the case , including… more
- University of Miami (Miami, FL)
- … utilization and prevent loss of reimbursement.UNIVERSITY OF MIAMICore_Sr. Manager , Financial Counseling11. Utilizes financial and decision support systems to ... Cell Administration is currently seeking a full time Sr. Manager , Financial Counseling to work in Miami. The Senior...staff. The incumbent supervises a team of SCT Finance Case Managers while supporting the following areas: Budgeting, Cost… more
- AdventHealth (Deland, FL)
- …W PLYMOUTH AVE, Deland, 32720 The role you'll contribute: The RN Care Manager in collaboration with the patient/family, social workers, nurses, physicians and the ... and progression through the continuum of care. The RN Care Manager ensures efficient and cost-effective care through appropriate resources monitoring, and… more