• Manager, Nursing (H)

    University of Miami (Miami, FL)
    …or responsibilities as necessary. CORE QUALIFICATIONS + Bachelor's degree in relevant field + Registered Nurse Licensure ( RN ), BLS, and ACLS Provider Card. + ... to apply for a faculty or staff position, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The University of… more
    University of Miami (12/20/25)
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  • Nurse Case Manager

    General Dynamics Information Technology (Hurlburt Field, FL)
    …certifying organization, ie Commission for Case Management Certification or American Nurse Credentialing Center. + Current RN license; full, active, and ... unrestricted license as a Registered Nurse in one of any US...all training/certs/documentation. + Knowledge and skill in using pre-established utilization review criteria recognize and report actual… more
    General Dynamics Information Technology (10/26/25)
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  • Clinical Reviewer, Nurse (Medical Oncology)

    Evolent (Tallahassee, FL)
    …the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks ... physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care… more
    Evolent (12/10/25)
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  • SQPE Specialist II

    Cleveland Clinic (Vero Beach, FL)
    …for the ideal future caregiver include: + Master's Degree + Licensure as a Registered Nurse ( RN ) + Clinical experience (will offset three years ... compliance with all standards and favorable performance on safety, quality, utilization and experience metrics. + Participate in engraining the safety, quality… more
    Cleveland Clinic (01/07/26)
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  • Payment Integrity Clinician

    Highmark Health (Tallahassee, FL)
    …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... and the proper action to complete the retrospective claim review with the goal of proper and timely payment...experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder… more
    Highmark Health (11/14/25)
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  • Data Management Lead

    Parexel (Tallahassee, FL)
    …mitigations and drive resolution with cross-functional stakeholders as part of the Risk Management Plan. + Review and analyze metrics to derive meaningful ... practices like version control and literate programming. + BSN, RN , RPh, Pharm D, PA, MPH, or other applicable...project-level resourcing of staff and staff assignments. + Regularly review and update Data Management resources to… more
    Parexel (10/11/25)
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  • Nurse Case Manager

    Battelle Memorial Institute (Eglin AFB, FL)
    …two years' nursing experience + Current, full, active, and unrestricted license as a Registered Nurse in any US State, the District of Columbia, Guam, Puerto ... within legal and professional parameters + Knowledge and skill in using pre-established utilization review criteria to recognize and report actual or potential… more
    Battelle Memorial Institute (12/30/25)
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  • Core Desk Coordinator - SoLe Mia

    University of Miami (North Miami, FL)
    …CORE QUALIFICATIONS Education: Bachelor of Science in nursing Certification and Licensing: Registered nurse license Experience: Minimum 5 years of relevant ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The University of… more
    University of Miami (12/20/25)
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  • VP of Quality and Patient Safety

    HCA Healthcare (Hudson, FL)
    …related field required; Master's Degree preferred .Current Florida licensure as a Registered Nurse preferred _**If serving as facility's primary Risk Manager, ... Healthcare Quality) OR CHCQM (Diplomate in American Board of Quality Assurance and Utilization Review Physicians) _Individuals without CPHQ or ABQUARP will be… more
    HCA Healthcare (12/30/25)
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  • OPO - Resource Triage Coordinator

    University of Miami (Miami, FL)
    …health field, ie, EMT/P or Respiratory Therapist. Certification and Licensing: + FL Registered Nurse license or certification as a Physician Assistant, or allied ... to apply for a faculty or staff position, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Life Alliance… more
    University of Miami (12/20/25)
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