• Nurse Audit Manager

    Humana (Tallahassee, FL)
    …where your clinical expertise and passion for accuracy will make a meaningful impact. As the Nurse Audit Manager , you will spearhead audit and validation ... relevant coding. + Identifies the root cause analysis of audit findings and submits recommendations for appropriate change management....skills to make an impact** **Required Qualifications** + Registered nurse (RN). + 5 or more years of clinical… more
    Humana (10/18/25)
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  • Clinical Assistant Nurse Manager

    Immigration and Customs Enforcement (Miami, FL)
    Summary The Clinical Assistant Nurse Manager supervises nursing services at ICE facilities, ensuring compliance with laws, policies, and standards. ... licensure, 5+ years of clinical experience. Reports to the Nurse Manager (NM) and Regional NM, serving...care, compliance with clinical and regulatory guidelines, overpayment, and audit recovery; and developing policy guidance for nursing care… more
    Immigration and Customs Enforcement (10/19/25)
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  • Clinical Nurse Manager (O-6 Billet)…

    Immigration and Customs Enforcement (Miami, FL)
    Summary The Clinical Nurse Manager oversees nursing services at ICE facilities, ensuring compliance with laws, regulations, and standards. Responsibilities ... Service Corps (IHSC), Office of Deputy Assistant Director of Clinical Services (DAD-CSU). The Nurse Manager (NM) will report directly to the Regional Nurse more
    Immigration and Customs Enforcement (10/05/25)
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  • Telephonic Nurse Case Manager Senior

    Elevance Health (Miami, FL)
    **Telephonic Nurse Case Manager Senior** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person ... in different states; therefore, Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager Senior** is responsible for care management within… more
    Elevance Health (10/18/25)
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  • Nurse Case Manager Senior

    Elevance Health (Tampa, FL)
    …Monday - Friday, 9am - 5:30pm (4 days) 11:30am - 8pm (1 day) EST** The ** Nurse Case Manager Senior** is responsible for care management within the scope of ... functions as preceptor for new care management staff. Participates in department audit activities. Position Requirements: + Requires BA/BS in a health related field… more
    Elevance Health (10/16/25)
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  • Clinical Research Nurse 2

    University of Miami (Plantation, FL)
    …Department of SCCC has an exciting opportunity for a Full Time Clinical Research Nurse 2 to work at the UHealth Medical campus in Miami, Fl Core Responsibilities:The ... Clinical Research Nurse 2 ensures the integrity and quality of clinical...summaries 12. Demonstrate the ability to support a clinical audit , including preparation, participation, documentation and follow up. 13.… more
    University of Miami (08/13/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Tampa, FL)
    …**PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** Certified Clinical Coder, Certified Medical Audit Specialists, Certified Case Manager , Certified Professional ... to clinical experience + Documents clinical review summaries, bill audit findings and audit details in the database + Provides supporting documentation for… more
    Molina Healthcare (09/06/25)
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  • RN Clinical Appeals Nurse

    Molina Healthcare (Orlando, FL)
    …following: + Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare ... outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases… more
    Molina Healthcare (10/18/25)
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  • Pharmacy Program Manager

    CVS Health (Tallahassee, FL)
    …travel if a plan sponsor requests pharmacist attendance for an onsite visit/assessment/ audit . The Pharmacy Program Manager role includes: -Collaborate with an ... with heart, each and every day. The Pharmacy Program Manager is an individual contributor (non-people manager )...interdisciplinary care management team ( nurse case managers, medical directors, dietitians, social workers) to… more
    CVS Health (10/18/25)
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  • Center Clinical Manager

    ChenMed (Pembroke Pines, FL)
    …expanding and we need great people to join our team. The Center Clinical Manager (CCM) is an active leadership role responsible for the day-to-day management of back ... that help the center meet/exceed organizational goals. The Center Clinical Manager demonstrates thorough knowledge and proficiency in healthcare data analytics,… more
    ChenMed (09/13/25)
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