• Manager Case Management

    HCA Healthcare (Gainesville, FL)
    …physical, psycho-social, financial). 1. Participates in IDT rounds, 1. Conducts utilization review , evaluates clinical information, and communicates findings to ... Health Assistance Fund that offers free employee-only coverage to full -time and part-time colleagues based on income. Learn more...on a timely basis in accordance with the NFRMC Utilization Review Plan and managed care contractual… more
    HCA Healthcare (08/02/25)
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  • Territory Account Manager - 64

    Rep-Lite (Orlando, FL)
    …improving patient access and outcomes Performance Metrics Include + Revenue and utilization growth + Physician referral network expansion + Report attribution ... Territory Account Manager Full -Time | Field-Based | Extensive Travel Required Overview...You will be responsible for expanding awareness, increasing treatment utilization in established accounts, and building a strong network… more
    Rep-Lite (06/13/25)
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  • Pharmacist

    Sedgwick (Tallahassee, FL)
    …narcotic use contract with client. + Maintains accurate record system of pharmacy utilization review and complex pharmacy reviews to include cost savings, ... trends, and data collection. + Interacts and coordinates work of physician advisors as needed; performs complex review of cases to identify referral for case… more
    Sedgwick (08/13/25)
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  • Medical Director - Mid West Region

    Humana (Tallahassee, FL)
    …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all… more
    Humana (08/08/25)
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  • Medical Director- South Central

    Humana (Tallahassee, FL)
    …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all… more
    Humana (07/11/25)
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  • Associate Medical Director - Orthopedic Spine

    Elevance Health (Tampa, FL)
    …+ Determines the medical necessity of requests using clinical criteria. + Performs physician -level case review of musculoskeletal utilization requests. + ... PM Central** **Virtual:** This role enables associates to work virtually full -time, with the exception of required in-person training sessions, providing maximum… more
    Elevance Health (08/02/25)
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  • Advanced Clinical Pharmacist

    HCA Healthcare (Ocala, FL)
    …+ Employee Health Assistance Fund that offers free employee-only coverage to full -time and part-time colleagues based on income. Learn more about Employee Benefits ... areas of critical thinking, interpersonal relationships, and technical skills. + Review non-formulary requests and provide overall formulary management for the… more
    HCA Healthcare (08/08/25)
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  • Assistant Professor, Medicine, General Internal…

    University of Miami (Miami, FL)
    …QI training + Improving patient satisfaction + Improving patient safety + Peer review , performance improvement, utilization review , root cause analysis, and ... the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Job Status: Full time Employee Type:… more
    University of Miami (05/24/25)
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  • CMO UChicago Medicine & AdventHealth…

    AdventHealth (Altamonte Springs, FL)
    GENERAL SUMMARY: The Chief Medical Officer (CMO) provides physician leadership and serves in an administrative capacity providing support to the assigned facility. ... that come with evidence based model approach. + Provides counsel and physician perspective at senior leadership discussions and action plans related to business… more
    AdventHealth (08/07/25)
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  • Case Manager RN

    Adecco US, Inc. (Altamonte Springs, FL)
    …experience in an acute clinical care setting or equivalent. . Previous care management, utilization review or discharge planning experience. . RN License in FL . ... 3- month assignment, with potential for extension or a full -time offer **Schedule:** Monday - Friday; 8:00 to 5:00...nursing facilities, custodial and ambulatory settings. . Consults with physician and other team members to ensure that care… more
    Adecco US, Inc. (08/01/25)
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