• Clinical Reviewer, Nurse -Surgery

    Evolent (Tallahassee, FL)
    …are applied appropriately. **Qualifications:** + Current, unrestricted state licensure as a Registered Nurse + Associate or Bachelors in Nursing (Must be ... in on-going training programs to ensure quality performance in compliance with applicable standards and regulations, as well as,...a Registered Nurse ) + Strong interpersonal and communication… more
    Evolent (08/19/25)
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  • Field Care Coordinator

    Humana (Orlando, FL)
    …with at least 2 years of relevant experience (Health Services, Social Work, Psychology) + Registered Nurse ( RN ), licensed in the state of Florida with at ... least 2 years of relevant experience. + Licensed Practical Nurse (LPN), licensed in the state of Florida, with...4 years of relevant experience + Prior experience with Medicare & Medicaid recipients + Minimum 2 years case… more
    Humana (07/22/25)
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  • Supervisor, Care Management

    Molina Healthcare (FL)
    …for contact are per ToC protocols. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational Nurse ... use of the electronic case management documentation system in compliance with standard Molina processes, standard documentation styles, and... Nurse (LPN) with experience in lieu of RN license. + OR Bachelor's or master's degree in… more
    Molina Healthcare (08/27/25)
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  • Director of Care Management FT Days

    AdventHealth (Minneola, FL)
    …expertise and experiences you'll need to succeed** **:** **EDUCATION AND EXPERIENCE REQUIRED:** Registered Nurse : BSN Social Worker: MSW or BSW Masters in ... above) experience in Care Management/Social Work leadership **EDUCATION AND EXPERIENCE PREFERRED:** Registered Nurse : MSN Social Worker: MSW with LCSW 5-7 years… more
    AdventHealth (08/23/25)
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  • Administrator in Charge, Nursing Support Services…

    University of Miami (Miami, FL)
    …degree in relevant field Master's Degree (Preferred) + Certification and Licensing: Registered Nurse Licensing ( RN ) Basic Life Support Certification ... by bridging operational gaps and enhancing nursing leadership. The (AIC) is a registered professional nurse who is responsible for overseeing the daily… more
    University of Miami (07/18/25)
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  • Utilization Management Nurse - Front End…

    Humana (Tallahassee, FL)
    …+ Must reside in the state of Florida + Bachelor's degree or higher + Licensed Registered Nurse ( RN ) in the state of Florida with no disciplinary action. ... and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
    Humana (08/27/25)
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  • Director Care Management

    AdventHealth (Tampa, FL)
    …procedures, and standards Qualifications **The expertise and experiences you'll need to succeed:** . Registered Nurse : BSN . Social Worker: MSW or BSW Masters in ... but not limited to: Coordination of Care, Centers for Medicare & Medicaid Services (CMS) Conditions of Participation, Discharge...experience in Care Management/Social Work leadership . State Specific RN license if a nurse This facility… more
    AdventHealth (08/07/25)
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  • Telephonic Behavior Health Care Manager

    Humana (Hallandale Beach, FL)
    …+ Bachelor's degree in social work or behavioral health-related field + Active licensed Registered Nurse , RN in the state of Florida without disciplinary ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
    Humana (07/15/25)
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  • VP Quality AdventHealth Central Florida Division…

    AdventHealth (Altamonte Springs, FL)
    …+ Current valid State of Florida or multi state license as a Registered Nurse . **_Licensure, Certification, or Registration Preferred_** _:_ Certification in a ... for execution to achieve clinical excellence and organizational accountabilities. ** Compliance /Regulatory Responsibility** : Executive oversight of submission, monitoring, and… more
    AdventHealth (08/07/25)
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  • APP, Supervisor - General Internal Medicine - Full…

    University of Miami (Miami, FL)
    …Providers supervises advance d practice providers (APPs) ( ie, Advanced Registered Nurse Practitioners, Physician Assistants etc.). Key responsibilities of ... as assigned by the Chief and/or clinic Medical Director + Experience with Medicare Advantage (65+) patient population preferred + Completion of Medicare annual… more
    University of Miami (06/16/25)
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