• Utilization Management Nurse

    CVS Health (Tallahassee, FL)
    …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... from work._ **Required Qualifications** + 1 year of varied UM ( utilization management ) experience within an **outpatient** setting, concurrent review… more
    CVS Health (08/15/25)
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  • Utilization Management Nurse

    CVS Health (Tallahassee, FL)
    …Must have active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing in EST zones.… more
    CVS Health (08/24/25)
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  • Utilization Management Nurse

    CVS Health (Tallahassee, FL)
    …procedures/services or initiate a Medical Director referral as needed. + Assists management with training new nurse reviewers/business partners or vendors to ... meet quality and metric expectations. **Required Qualifications** + Registered Nurse (RN) - active license. + 3+ Years of...3+ Years of clinical experience. + 1+ Year of Utilization Review Management and/or Medical Management more
    CVS Health (08/15/25)
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  • Human Services Program Consultant II

    MyFlorida (Orlando, FL)
    …Bachelor's Degree in any other discipline with at least 6 months of direct case management experience or a Florida Licensed Registered Nurse (RN) with 1-year of ... HUMAN SERVICES PROGRAM CONSULTANT II - 64006362 Date: Aug 1, 2025...(CBO's). Incumbent reports directly to the Supervisor of Case Management . Staff will establish and maintain a caseload of… more
    MyFlorida (07/08/25)
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  • Program Administrator - SES - 1

    MyFlorida (Largo, FL)
    …Facility, or other long-term care setting. + Regional experience as a clinical Nurse Consultant in an organization that delivers and/or monitors health care ... Paid holidays and personal day. Retirement package. REQUIREMENTS + Unencumbered Florida Registered Nurse License. + Must be willing and able to travel throughout all… more
    MyFlorida (08/19/25)
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  • Pharmacist (Clinical Specialist) - Anticoagulation…

    Veterans Affairs, Veterans Health Administration (West Palm Beach, FL)
    …who functions to initiate, modify or discontinue medication therapy and as a consultant for intensive medication therapy management services. This includes, but ... as physician consultation, patient monitoring, patient counseling and medication management services within the anticoagulation framework. The incumbent is… more
    Veterans Affairs, Veterans Health Administration (08/23/25)
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  • SQPE Specialist I

    Cleveland Clinic (Stuart, FL)
    …compliance with all standards and favorable performance on safety, quality, utilization , and experience metrics. + Participate in engraining the safety, quality, ... data and participate in improvement strategy development. + Act as a consultant in educating and evaluating clinical and support department staff regarding quality… more
    Cleveland Clinic (08/08/25)
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  • Acute Care Manager

    Trinity Health (Fort Lauderdale, FL)
    …with members of the interprofessional acute care, ambulatory and post-acute care management teams to improve communication across the continuum of care. * ... that have been documented in the medical record. * Serves as a consultant and educator with medical staff regarding status, placement, payer requirements, and … more
    Trinity Health (08/23/25)
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