• RN Case Manager Evenings

    HCA Healthcare (Tallahassee, FL)
    …throughput while supporting a balance of optimal care and appropriate resource utilization . The RN CM Care Coordinator will identify potential barriers to patient ... processes, for the appropriate level of care, patient status and resource utilization + Conducts interdisciplinary team meetings to provide a mechanism for all… more
    HCA Healthcare (11/10/25)
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  • RN Case Manager

    HCA Healthcare (Tallahassee, FL)
    …throughput while supporting a balance of optimal care and appropriate resource utilization . The RN CM Care Coordinator will identify potential barriers to patient ... processes, for the appropriate level of care, patient status and resource utilization + Conducts interdisciplinary team meetings to provide a mechanism for all… more
    HCA Healthcare (11/10/25)
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  • Field Medical Director, Radiology (Neurology)

    Evolent (Tallahassee, FL)
    …Doing:** Job Description As a FMD, Radiology you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in ... to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization more
    Evolent (10/31/25)
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  • Staffing Optimization Analyst

    HCA Healthcare (St. Petersburg, FL)
    …PI labor and facility leaders and executives to ensure optimal utilization to support staffing requirements/expectations. This individual should possess excellent ... other Financial Resiliency initiatives to include but not limited to PRN utilization , overtime, weekend commitment, and under/over commitment. + Responsible for the… more
    HCA Healthcare (10/10/25)
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  • Facilities Mapping & Documentation Coordinator

    Florida Atlantic University (Boca Raton, FL)
    …Mapping and Documentation Coordinator reports directly to the Director of Space Utilization or designee and serves all University sites and campuses. This position ... of infrastructure drawings, specifications and as-built records. + Space Planning and Utilization : + Collect relevant data for space utilization studies to… more
    Florida Atlantic University (10/03/25)
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  • Senior Analyst, Medical Economics

    Molina Healthcare (FL)
    …to medical care costs. * Analyzes the financial performance, including cost, utilization and revenue of all Molina products - identifying favorable and unfavorable ... Tableau and data management. * Knowledge of health care operations ( utilization management, disease management, HEDIS quality measures, claims processing, etc.) *… more
    Molina Healthcare (12/14/25)
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  • Health Network Strategy Executive

    Oracle (Tallahassee, FL)
    …with healthcare executives, clinical leaders, and IT teams to drive adoption and utilization of the Oracle Population Health suite. o Provide expert guidance on ... to continuously assess and identify opportunities for expansion and deeper utilization of Oracle Population Health solutions across the organization. o Identify… more
    Oracle (12/14/25)
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  • Clinical Review Nurse - Concurrent Review

    Centene Corporation (Tallahassee, FL)
    …taken on member medical records in health management systems according to utilization management policies and guidelines + Works with healthcare providers to approve ... and concurrent review findings + Assists with providing education to providers on utilization processes to ensure high quality appropriate care to members + Provides… more
    Centene Corporation (12/14/25)
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  • LTSS Service Coordinator - Case Manager…

    Elevance Health (Cape Coral, FL)
    …chronic illnesses, co-morbidities, and/or disabilities, to ensure cost effective and efficient utilization of long-term services and supports. + At the direction of ... and may be involved in process improvement initiatives. + Submits utilization /authorization requests to utilization management with documentation supporting and… more
    Elevance Health (12/13/25)
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  • Care Review Clinician (RN)

    Molina Healthcare (FL)
    …with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At least 2 ... or emergency room. Preferred Experience Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual /… more
    Molina Healthcare (12/13/25)
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