• Human Services Program Consultant II

    MyFlorida (Orlando, FL)
    …at least 6 months of direct case management experience or a Florida Licensed Registered Nurse ( RN ) with 1-year of direct case management experience ... into additional databases or systems, following established guidelines for case management reimbursement, and ensuring compliance with Client Service Records… more
    MyFlorida (07/08/25)
    - Related Jobs
  • Program Manager, HCS

    Molina Healthcare (Jacksonville, FL)
    …materials and other related documentations. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational ... Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of ...years in one or more of the following areas: utilization management , case management , care… more
    Molina Healthcare (08/02/25)
    - Related Jobs
  • National Director, Care Integration Strategy…

    CenterWell (Tallahassee, FL)
    …Coordinate quality improvement activities to address high risk, high-utilizers/high-cost patient management through the utilization of the 5M's framework as ... will play a pivotal role in reducing acute care utilization for top 5% of complex patients and ensuring...highest need and complexity patients with care and case management services. The Director is response for the strategic… more
    CenterWell (08/15/25)
    - Related Jobs
  • Prior Authorization Nurse

    Actalent (Sunrise, FL)
    Utilization Management Nurse !Job Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing service authorization ... present reports on department activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management + Interqual + Milliman… more
    Actalent (08/17/25)
    - Related Jobs
  • Hybrid Manager, Care Management

    CenterWell (Tampa, FL)
    …of our caring community and help us put health first** The Manager Care/Case Management in **Tampa area (** **_this is not a remote position_** **)** is responsible ... managing populations and coordinating care to reduce acute and post-acute care utilization . The Manager role is hybrid with travel requirements to preferred… more
    CenterWell (08/08/25)
    - Related Jobs
  • SQPE Specialist I

    Cleveland Clinic (Stuart, FL)
    …Preferred qualifications for the ideal future caregiver include: + Masters degree + Registered Nurse ( RN ) + Certified Patient Safety Professional (CPPS) ... and behavioral standards. + Coordinate with cross functional stakeholders to ensure compliance with all standards and favorable performance on safety, quality, … more
    Cleveland Clinic (08/08/25)
    - Related Jobs
  • 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 ... and engage formerly acquired skillsets to: + Perform care management of pediatric members (under 21) who utilize Applied...psycho-social health issues. + Monitor and maintain awareness of utilization and conducts outreach based on acuity to assess… more
    Humana (07/15/25)
    - Related Jobs
  • Senior Nurse Manager Med Surg Medical Unit…

    AdventHealth (Davenport, FL)
    …experience Current valid State of Florida or multi state license as a Registered Nurse **Preferred expertise and experience:** + Six (6) months experience ... central hub of tourism. **The role you'll contribute:** The Nurse Manager (NM) is a registered professional...resources to achieve quality performance, positive employee relations, and compliance with hospital guidelines. The NM is skilled in… more
    AdventHealth (08/09/25)
    - Related Jobs
  • Director Cardiovascular Services

    HCA Healthcare (Pensacola, FL)
    …* 3+ years of experience in a leadership role ​​Preferred​ Licenses & Certifications * ​​ Registered Nurse - Currently licensed as a registered professional ... labor management , including position control, scheduling excellence, productivity management , and premium pay utilization . Maintains staffing to ensure… more
    HCA Healthcare (07/03/25)
    - Related Jobs
  • Director Of Nursing

    MTC (Quincy, FL)
    …performing the duties of the position. 11. Practice advanced cost containment and utilization management for inmate care and facility operations. 12. Maintain ... leave + Opportunities for job advancement Impact lives with Management & Training Corporation (MTC)! At the **Gadsden Correctional...one (1) year supervisory experience. Must be a licensed registered nurse in the state of Florida… more
    MTC (08/08/25)
    - Related Jobs