• Registered Nurse RN - Utilization Review

    Ascension Health (Pensacola, FL)
    …assigned unit for prospective, concurrent and retrospective medical necessity and/or compliance with reimbursement policy criteria. + Provide case management and/or ... analysis and utilization review reports as necessary. + Oversee and coordinate compliance to federally mandated and third party payer utilization management rules… more
    Ascension Health (06/04/25)
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  • Senior Manager, Clinical Product…

    Edwards Lifesciences (Tallahassee, FL)
    …understand nature of complaints and possible health risks; Interprets complaint data for Quality compliance staff, complaint investigators and other Quality ... us and be part of our inspiring journey. The Senior Manager, Clinical Product Quality will plan...plus. + Supervisory or people leadership experience. + Registered nurse with current state license in good standing **What… more
    Edwards Lifesciences (06/04/25)
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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 ... team members and resources. Maintains focus on all healthcare quality and affordability initiatives (HCQAI's). Established productivity standards and performance… more
    CenterWell (04/17/25)
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  • RN Nurse Manager Family Birth Place

    Ascension Health (Middleburg, FL)
    …Critical Care, Labor & Delivery/Women & Family. Responsibilities: + Ensure compliance with regulatory and accreditation requirements for self and within the ... health services in the unit(s). + Develop and maintain quality monitoring systems for the assigned unit(s). + Monitor...or monitors expenditures, purchases and other actions to ensure compliance with budget guidelines. + Ensure a high level… more
    Ascension Health (05/31/25)
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  • Associate / Full Professor & Senior

    University of Florida (Gainesville, FL)
    Associate / Full Professor & Senior Associate Dean of Academic Programs Apply now ... PhD, DNP, or EdD with extensive experience in nursing education for this senior leadership position. This is a full-time, twelve-month, 1.0 FTE position at the… more
    University of Florida (05/22/25)
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  • Senior Clinical Strategy Consultant

    Highmark Health (Tallahassee, FL)
    …Develop and deliver compelling clinical narratives designed to influence senior -level decision-makers at client organizations, securing commitment to proposed ... solutions. + Provide Senior Level Clinical Sales Support: Collaborate with Sales to...**SKILLS** + Deep Clincal Expertise -extensive knowledge of clinical, quality , care, utilization, high-cost claim, and population health management.… more
    Highmark Health (05/10/25)
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  • Senior Accreditation Professional

    Humana (Tallahassee, FL)
    …of our caring community and help us put health first** We are seeking a Senior Accreditation Professional who will work in a team environment on Humana's health plan ... accreditations, performing complex tasks related to compliance with accreditation standards across multiple operational areas within Humana. **Role… more
    Humana (06/06/25)
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  • Senior Manager Operations - EMS

    AdventHealth (Wesley Chapel, FL)
    …has the knowledge to oversee the utilization of resources to achieve quality performance, positive employee relations, and compliance with departmental ... contribute:** The Sr. Manager Operations is a registered Paramedic, registered Nurse , or registered Respiratory Therapist who has 24-hour responsibility for the… more
    AdventHealth (06/02/25)
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  • Senior Supplier Recovery Leader

    GE Aerospace (Jacksonville, FL)
    …locations as needed. **Job Description** **Essential Responsibilities:** As the Senior Supplier Recovery Leader, key responsibilities will include: + Represent ... gaps including GE Aerospace teams + Develop strategies to meet the quality , fulfillment, and productivity requirements of the business + Earn authority within… more
    GE Aerospace (05/09/25)
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  • Pediatric Senior LTSS Service Care Manager

    Centene Corporation (Lauderhill, FL)
    …plans, implements, and coordinates holistic care management activities to enable quality , cost- effective healthcare outcomes. May develop or assist with developing ... long-term care member data to identify trends and improve operating performance and quality care in accordance with state and federal regulations + Reviews referrals… more
    Centene Corporation (06/06/25)
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