- Molina Healthcare (Jacksonville, FL)
- …Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + ... For this position we are seeking a (RN) Registered Nurse who must be licensed for the state they...be required. + Serves as a clinical resource for Utilization Management , Chief Medical Officer, Physicians, and… more
- AdventHealth (Altamonte Springs, FL)
- …Support Registered Nurse is responsible for providing telephonic medical case management for Workers Compensation Injury cases. Case Management is a ... you'll bring to the team:** + Provide telephonic case management for multi-state claim caseload assignment (excluding GA: written...written consent required, and NC: must be registered rehab nurse with NCIC) + Reports directly to the WC… more
- CenterWell (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... high-volume community or mail order pharmacy practice environment + Previous experience in utilization management + Education: BSN or Bachelor's degree in a… more
- ChenMed (Winter Park, FL)
- …license required if available in state. + A minimum of 2 years' onsite case management at ChenMed and/or utilization review or discharge planning in a hospital ... markets to deliver on managing their case load by providing onsite and remote planning, clinical group leadership and expert technical guidance to their team.… more
- MyFlorida (Tallahassee, FL)
- …medical community. The position is supervised by a School Health Nursing Director. Case Management Provide in-person and remote case management for students' ... OPS REGISTERED NURSE - 64937233 Date: Jul 8, 2025 The...the student, the parent/guardian, and the medical community. Inventory Management Ensure subordinates accurately inventory all medications in the… more
- AdventHealth (Orlando, FL)
- …role you'll contribute:** The Population Health Case Manager (PHCM) ensures effective utilization and case management oversight activities as defined by inter ... through Friday 8:00 am to 5:00 pm **Location:** Virtual Remote near 602 COURTLAND ST, Orlando, FL, 32804 **The...in home health + 2 years of experience in management position. + Registered Nurse State Licensure… more
- GetWellNetwork, Inc. (Tampa, FL)
- …Manager will take the Get Well program to the next level by driving nurse engagement, focusing on increased utilization , and leading projects of functionality to ... Facility. Get Well's Client Success Manager is responsible for effective product utilization and successful outcomes for the Get Well system at their designated… more
- Bluestone Physician Services (Wesley Chapel, FL)
- …with primary care teams to ensure high quality team-based care + Use utilization management tools to facilitate appropriate transitional care management ... their unique needs. Using an evidence-based approach focused on quality care management and data-driven medical decisions, Bluestone care teams collaborate to manage… more
- Humana (Hallandale Beach, FL)
- …and requirements to achieve and/or maintain optimal wellness state in a remote telephonic environment. The Behavioral Health Care Manager guides members and/or ... employers offering a variety of professional onsite, field, or remote based opportunities for a period up to 11...and engage formerly acquired skillsets to: + Perform care management of pediatric members (under 21) who utilize Applied… more
- GE Aerospace (Jacksonville, FL)
- …a change agent for business processes related to Government Property (GP) management at subcontractor and affiliate sites, driving improvements and compliance. + ... Provide assistance with the management of the GP subcontractor and affiliate risk assessment and surveillance audit process to ensure compliance and mitigate risks.… more