• Director of Medical Management

    DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
    … management initiatives and programs. + Oversees a staff of Hospital Reviewers/ Utilization Managers, Medical Management Coordinator RNs, Medical ... responsible for the strategic direction, leadership, and oversight of all medical management functions, including Utilization Management , and Quality… more
    DOCTORS HEALTHCARE PLANS, INC. (09/14/25)
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  • Case Manager, Registered Nurse…

    CVS Health (Tallahassee, FL)
    …**Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse care coordinator experience as well ... is URAC accredited in Case Management , Disease Management and Utilization Management . AHH...reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year… more
    CVS Health (08/15/25)
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  • Registered Nurse -Clinical Project…

    AdventHealth (Kissimmee, FL)
    …of Acute Care experience + Current valid State of Florida or Multi State license as a Registered Nurse ( RN ) + Basic Life Support (BLS) This facility is an ... contribute:** Under the direction of the leadership team, the Clinical Coordinator /Project Manager will provide project coordination and support with strong… more
    AdventHealth (08/23/25)
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  • SNF Utilization Management RN…

    Humana (Tallahassee, FL)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **​Licensed Registered Nurse ( RN )** in the… more
    Humana (09/12/25)
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  • RN Stroke Program Coordinator

    HCA Healthcare (Orange Park, FL)
    …safety and customer service of the patient first.** **What qualifications you will need:** + ( RN ) Registered Nurse in the state in which you practice + ... **Introduction** Do you have the career opportunities as an RN Stroke Program Coordinator you want in...Associate Degree, or Bachelors Degree, or Registered Nurse Diploma + APRN preferred +… more
    HCA Healthcare (08/30/25)
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  • Utilization Coordinator - Homecare

    BayCare Health System (Largo, FL)
    …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Coordinator (Homecare) responsibilities include:** + Coordinates ... Community discounts and more Equal Opportunity Employer Veterans/Disabled **Position** Utilization Coordinator - Homecare **Location** US:Florida:Largo:HomeCare Largo… more
    BayCare Health System (09/04/25)
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  • Medical Management Coordinator…

    DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
    …requests. + Reviews cases referred by the prior-authorization non-clinical medical management coordinator and pre-certification technician staff according to ... and goals. + Clearly and succinctly documents necessary and/or required information in Utilization Management system. + Monitors and complies with all state,… more
    DOCTORS HEALTHCARE PLANS, INC. (09/14/25)
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  • RN Case Manager PRN

    HCA Healthcare (Tallahassee, FL)
    …of clinical care, medical necessity, admission status, level of care, and resource management . The RN CM Care Coordinator will coordinate activities ... supporting a balance of optimal care and appropriate resource utilization . The RN CM Care Coordinator...required within 90 days of hire** + **Advanced Practice Registered Nurse license is acceptable for position… more
    HCA Healthcare (09/19/25)
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  • RN Case Manager

    HCA Healthcare (Tallahassee, FL)
    …of clinical care, medical necessity, admission status, level of care, and resource management . The RN CM Care Coordinator will coordinate activities ... supporting a balance of optimal care and appropriate resource utilization . The RN CM Care Coordinator...required within 90 days of hire** + **Advanced Practice Registered Nurse license is acceptable for position… more
    HCA Healthcare (09/21/25)
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  • LTSS Service Coordinator -LPN Case Manager…

    Elevance Health (Pinellas Park, FL)
    **LTSS Service Coordinator - Clinician (Bilingual in Spanish/English)** **Location: This is a field based position, candidate would need travel in and around the ... granted as required by law._ **Schedule: Monday-Friday 8am-5pm EST** The **LTSS Service Coordinator - Clinician** works under the direction/supervision of an RN ,… more
    Elevance Health (09/09/25)
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