• Utilization Review Nurse

    Actalent (Sunrise, FL)
    Utilization Management Nurse !Job Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing service authorization requests to ... of education and experience. + Valid Florida Driver's License. + Knowledge of case management and utilization review concepts, including InterQual and Milliman… more
    Actalent (08/21/25)
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  • Registered Nurse Neuro Operating Room…

    AdventHealth (Orlando, FL)
    …role specific related duties which may include but are not limited to supply management , case preparation, and equipment set up, and troubleshooting. May also ... Media Tech Assistant_ will also work under supervision of the professional nurse , assisting in performing specific duties and activities for surgical patients of… more
    AdventHealth (08/07/25)
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  • Clinical Appeals Nurse (RN)

    Molina Healthcare (Tampa, FL)
    …Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management + Certified Professional in ... outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases… more
    Molina Healthcare (08/15/25)
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  • Registered Nurse CAA Home Health Weekend

    CenterWell (The Villages, FL)
    …first** Make a meaningful impact every day as a CenterWell Home Health nurse . You'll provide personalized, one-on-one care that helps patients regain independence in ... members, attending physicians, appropriate administrative staff, referral sources and external case managers to ensure appropriateness of care + coordination and… more
    CenterWell (07/17/25)
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  • Manager Care Management

    AdventHealth (Daytona Beach, FL)
    …301 MEMORIAL MEDICAL PKWY, Daytona Beach, 32117 **The role you'll contribute:** The Care Management Manager is under the general leadership of the Care ... of the departmental daily operations and supervision of team members. The Care Management Manager is responsible for, but not limited to: Coordination of… more
    AdventHealth (08/14/25)
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  • Manager Care Management

    AdventHealth (Orlando, FL)
    …32,000 inpatients and 125,000 outpatients each year **The role you'll contribute:** **The Care Management Manager is under the general leadership of the Care ... of the departmental daily operations and supervision of team members.** **The Care Management Manager is responsible for, but not limited to: Coordination of… more
    AdventHealth (08/07/25)
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  • RN Manager Care Management

    AdventHealth (Sebring, FL)
    …International Raceway . Nature and hiking trails **The role you'll contribute:** The Care Management Manager is under the general leadership of the Care ... of the departmental daily operations and supervision of team members. The Care Management Manager is responsible for, but not limited to: Coordination of… more
    AdventHealth (08/16/25)
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  • Intensive Community Manager , Complex Care…

    ChenMed (Jacksonville, FL)
    …in community case management experience highly desired + Certified Case Manager certification is preferred. Certification through the Commission for ... may need and to oversee appropriate patient discharge from case management . + Performs clinical, fall prevention,...Case Manager Certification (CCMC) or the American… more
    ChenMed (07/29/25)
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  • RN Care Manager - DSNP

    Molina Healthcare (FL)
    …for Registered Nurses who have experience working with manage care population and/or case management role. Excellent computer skills and diligence are especially ... assessments of members per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or… more
    Molina Healthcare (08/23/25)
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  • Clinical Documentation Manager

    AdventHealth (Celebration, FL)
    …each position may vary based on geographical location. **Category:** Case Management **Organization:** AdventHealth Celebration **Schedule:** Full-time ... disease **The role you'll contribute:** The Clinical Documentation Integrity Manager is a Registered Nurse and/or a... Management Program (CDMP) at AdventHealth. This includes management of the case mix index (CMI),… more
    AdventHealth (08/13/25)
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