Registered Nurse Care Manager -Value Based Care (Must Reside in FL) Cardiovascular Associates of AmericaRegistered Nurse Care Manager -Value Based Care (Must Reside in FL)Orlando, FLRemoteFull timeClinical Program Execution & Management Deliver end-to-end clinical care management, including triage, high-risk care management, and transitional care management for complex cardiac patients. Headquartered in Orlando area, Cardiovascular Associates of America aims to bring the best cardiovascular physicians in one network with the common mission of saving lives, reducing costs, and improving patient care through clinical innovation.
NewSenior Stars Clinical Consultant RN Humana IncSenior Stars Clinical Consultant RNFLRemote$78,400–$107,800 / yearWork at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. This role is remote/virtual, but candidates may travel to provider offices within the state of Florida up to 30% and travel to Tampa or South Florida Humana market offices within region for in person meetings.
Remote Hospice Triage RN FT Monday-Friday 6:30A-4P (No Wknds) IntellaTriageRemote Hospice Triage RN FT Monday-Friday 6:30A-4P (No Wknds)Orlando, FLRemoteUtilizing best-in-class technology, IntellaTriage provides round-the-clock direct access to licensed, registered nurses using client-customized protocols for patient-centered, compassionate care. Built around a mission to improve the lives of nurses and patients, IntellaTriage has been providing after-hours nurse triage for hospice and home health providers since 2008.
Remote Registered Nurse RN RylemRemote Registered Nurse RNJacksonville, FLRemote$25–$28 / hourFull timePart timeWe’re looking for an experienced Registered Nurse Clinical Documentation Specialist to join a high-performing healthcare team in a fully remote role! If you have a strong CDI background and acute care experience, this is your chance to work from home while earning competitive travel pay.
Clinical Preceptor - RN Paradigm Management Services LLCClinical Preceptor - RNTampa, FLRemoteIntermediate computer skills including working knowledge of the Internet, MS Word, MS Outlook, MS Excel, MS PowerPoint and other tools/programs utilized for distance learning and webinar presentations. Experience as a Network Manager, managing catastrophic injury and chronic pain conditions, demonstrating knowledge of case management services provided for catastrophically injured individuals.
NewUtilization Management Nurse HumanaUtilization Management NurseFloridaRemoteWork at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Reports to the UM Nurse, Manager The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care or services for members.
Care Manager (RN) Centene Corporation GroupCare Manager (RN)FLRemote$56,200–$101,000 / yearPosition Purpose: Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families. Provides resource support to members and care managers for local resources for various services (e.g., employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans, as appropriate.
Nurse Manager - Remote (RN Compact License Required) Call 4 HealthNurse Manager - Remote (RN Compact License Required)FloridaRemoteThis leadership role requires a licensed Registered Nurse (RN) with strong Operations and Triage expertise, managerial experience, and the ability to foster a supportive, high-performance work environment. The Nurse Manager at Call 4 Health will oversee the daily operations of the Nurse Triage team, ensuring the highest quality of patient care, compliance with healthcare regulations, and optimal staff performance.
Field Care Coordinator- Bilingual preferred Humana IncField Care Coordinator- Bilingual preferredCoral Springs, FLRemote$60,000–$65,000 / yearThe Care Coach 1 role involves meeting members in their location, spending quality time assessing their needs and barriers and then connecting our members with quality services to promote their ultimate well-being and drive health outcomes. The Care Coach evaluates member''s needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members.
Remote Hospice Triage RN FT Monday-Friday 6:30a-4p (No Wknds) IntellaTriage, Inc.Remote Hospice Triage RN FT Monday-Friday 6:30a-4p (No Wknds)Orlando, FLRemoteUtilizing best-in-class technology, IntellaTriage provides round-the-clock direct access to licensed, registered nurses using client-customized protocols for patient-centered, compassionate care. Built around a mission to improve the lives of nurses and patients, IntellaTriage has been providing after-hours nurse triage for hospice and home health providers since 2008.
NewCompliance UM Nurse (Wed - Sun) Humana IncCompliance UM Nurse (Wed - Sun)FLRemote$71,100–$97,800 / yearWork at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it.
NewOnsite Care Coordination Nurse HumanaOnsite Care Coordination NursePensacola, FloridaRemoteWork at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$71,100 - $97,800 per yearThis job is eligible for a bonus incentive plan.
Case Manager / RN (licensed in all 50 states) MedWatchCase Manager / RN (licensed in all 50 states)Lake Mary, FLRemote$72,000–$81,000 / yearThe Case Manager will work in conjunction with the Case Management Assistant to manage case management files, exclusive of Assessment and/or Care Plan activities, and will provide input in the Annual Performance Evaluation of the CM Assistant assigned. If there are no benefits available for your recommended alternative treatments, provide to the payer a cost-benefit analysis to demonstrate that extra-contractual services will enhance the patient’s medical condition and will be cost-effective to the benefit plan.
Case Manager / RN MedWatchCase Manager / RNLake Mary, FLRemote$72,000–$81,000 / yearThe Case Manager will work in conjunction with the Case Management Assistant to manage case management files, exclusive of Assessment and/or Care Plan activities, and will provide input in the Annual Performance Evaluation of the CM Assistant assigned. If there are no benefits available for your recommended alternative treatments, provide to the payer a cost-benefit analysis to demonstrate that extra-contractual services will enhance the patient’s medical condition and will be cost-effective to the benefit plan.
Remote Registered Nurse (Remote Patient Monitoring & Chronic Care Management) 3:15Remote Registered Nurse (Remote Patient Monitoring & Chronic Care Management)Tampa, FLRemoteAssist patients in the navigation of their healthcare (example - assisting patients with scheduling appointments, coordinating with specialists, and ensuring preventative screenings are completed, etc.). We are looking for a qualified Registered Nurse (RN) to serve our patient population in the navigation, prevention and management of their health through continuous care programs like Remote Patient Monitoring and Chronic Care Management.
Medical Case Manager (Registered Nurse) AmTrust Financial Services, Inc.Medical Case Manager (Registered Nurse)TBD, FloridaRemote$80,000–$88,000 / yearFull timeResponsible for helping to ensure injured employees receive appropriate level and intensity of care through use of medical and disability duration guidelines, directly related to the compensable injury and/or assist adjusters in managing medical treatment to drive resolution. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines.
Maternal Child Clinical Nursing Instructor (Part-Time) Covista IncMaternal Child Clinical Nursing Instructor (Part-Time)Jacksonville, FLRemoteFrom individual professor support and student-led study groups to diverse clinical and career networking opportunities, the institution"s community shares a common goal: to give each other the care we need to succeed and make a difference by transforming healthcare. With more than 135 years of history in healthcare education and as the largest nursing school in the country, Chamberlain University is committed to delivering a high-value education that prepares students to thrive as healthcare professionals.
Medical Review Nurse - CMS RAC (Government audits) Performant Healthcare IncMedical Review Nurse - CMS RAC (Government audits)Plantation, FLRemote$81,000–$90,000 / yearRegularly sits at a desk during scheduled shift, uses office phone or headset provided by the Company for phone calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a computer mouse. Deployed by over 75 health plans, including many of the top 20, and representing more than 170 million lives, Machinify's AI operating system, combined with proven expertise, untangles healthcare data to deliver industry-leading speed, quality, and accuracy.
Pool Resuscitation Educator, Remote, Resuscitation Education, Palm Beach County, Per Diem, Varies Baptist Health South FloridaPool Resuscitation Educator, Remote, Resuscitation Education, Palm Beach County, Per Diem, VariesMiami, FLRemoteResuscitation educators are involved in the design, delivery, evaluation, and coordination of best practice resuscitation activities for the education of BHSF staff requiring resuscitation certifications (BLS, ACLS, PALS, NRP) as part of their job description requirements. The Pool Resuscitation Educator structures the learning environment for positive student outcomes throughout the different resuscitation education courses and activities.
RN Telehealth Total LifeRN TelehealthFloridaRemoteThe RN will provide structured monthly patient engagement and coordinate care within a multidisciplinary team that includes psychiatry, nurse practitioners/physician assistants, psychology, and nutrition services. This is an ideal opportunity for an RN who is passionate about relationship-based care, proactive patient engagement, and supporting medically and emotionally complex geriatric patients within a collaborative behavioral health model.
Medical Review Nurse - CMS RAC (Government audits) PerformantMedical Review Nurse - CMS RAC (Government audits)Plantation, FloridaRemoteRegularly sits at a desk during scheduled shift, uses office phone or headset provided by the Company for phone calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a computer mouse. Deployed by over 75 health plans, including many of the top 20, and representing more than 170 million lives, Machinify’s AI operating system, combined with proven expertise, untangles healthcare data to deliver industry-leading speed, quality, and accuracy.
Care Review Clinician (RN) - Remote in FL Molina Healthcare IncCare Review Clinician (RN) - Remote in FLFLRemoteResponsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience.
Care Review Clinician (RN) Remote Molina Healthcare IncCare Review Clinician (RN) RemoteFLRemoteResponsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience.
Travel Nurse Trainer (Remote) DermaVe SpaTravel Nurse Trainer (Remote)Tampa, FLRemote$22–$27 / hourYou'll help launch new locations , train junior nurses, and ensure every spa delivers top-notch care. You'll start in Sarasota, Florida for onboarding and training with our leadership team, then travel to new locations as needed.
Travel Nurse Trainer - Remote with Occasional Travel (Remote) DermaVe SpaTravel Nurse Trainer - Remote with Occasional Travel (Remote)Orlando, FLRemote$22–$27 / hourRole Overview We are seeking a licensed RN or APRN with experience in aesthetic or med spa settings to develop training programs for nurses and estheticians. Provide mentorship and support to junior nurses across spa locations.
Remote Travel Nurse Trainer – Licensed RN or APRN (Remote) DermaVe SpaRemote Travel Nurse Trainer – Licensed RN or APRN (Remote)St. Petersburg, FLRemote$22–$27 / hourPosition: Remote Travel Nurse Trainer – Licensed RN or APRN Type: Full-Time, Travel Nursing. You will work with leadership to improve training programs and ensure consistency across locations.
Analyst, Health Plan Risk & Quality Reporting (Remote in FL) Molina Healthcare IncAnalyst, Health Plan Risk & Quality Reporting (Remote in FL)Miami, FLRemoteAnalyzes data sets and trends for anomalies, outliers, trend changes, and opportunities, using databricks Structured Query Language (SQL), PowerBi, Microsoft Excel, and techniques to determine significance and relevance. At least 2 years of experience mapping, scrubbing, scrapping, and cleaning data, and analysis experience related to HEDIS and/or risk adjustment, and 1 year of experience in a managed care organization, or equivalent combination of relevant education and experience.
Medicare Advantage Appeals RN - Remote BayCare Health SystemMedicare Advantage Appeals RN - RemoteClearwater, FLRemoteCollaborates with physicians, providers, vendors, and internal departments to ensure accurate, fair, and timely determinations while maintaining thorough documentation and data integrity. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians.
Remote Registered Nurse (RN) Case Manager ValerisRemote Registered Nurse (RN) Case ManagerOrlando, FloridaRemoteBacked by proven industry expertise, a deep commitment to patient care, the latest technology, and exceptionally talented team members, Valeris provides the data and strategic insights, patient support services and healthcare provider engagement tools to help life sciences companies successfully commercialize new products. calling and working with the patient’s insurance payer to determine coverage benefits, anticipated out-of-pocket costs associated with their therapy and resources for financial assistance, where applicable based upon needs communicated by the patient.
Nurse Navigator 1 - Site Disease Group - Full Time/Remote University of MiamiNurse Navigator 1 - Site Disease Group - Full Time/RemoteMiami, FLRemoteReview the worklist of AI-flagged incidental nodules identified from radiology reports, and validate nodule characteristics, urgency, and the appropriate next-step pathway in collaboration with the advanced practice provider (APP) and clinical lead. The Nurse Navigator 1 (H) is the initial point of contact for a patient entering the health system and assures timely scheduling of the first appointment, and coordination of care after completion of the first appointment and supports the patient throughout the care continuum.
Pool Resuscitation Educator, Remote, Resuscitation Education, Palm Beach County, Per Diem, VARIES Baptist Health South Florida IncPool Resuscitation Educator, Remote, Resuscitation Education, Palm Beach County, Per Diem, VARIESMiami, FLRemoteOur approach is rooted in a "grow our own" philosophy, designed to help our team members build meaningful, long-term careers with us, supported by benefits that make a real difference, including: Career growth and development opportunities, with clear pathways and ongoing support. Baptist Health is the region''s largest not-for-profit healthcare organization, with 12 hospitals, over 29,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties.
Clinical Nurse Manager Travel Staffing Ascension Health AllianceClinical Nurse Manager Travel StaffingJacksonville, FLRemote$107,821–$145,875 / yearOur legitimate email communications will always come from an @ascension.org email address; do not trust other domains, and an official offer will only be extended to candidates who have completed a job application through our authorized applicant tracking system. Education: Required professional licensure/certification AND 3 years of experience and 1 year of cumulative leadership experience required.
NewSenior Manager, Clinical and Coding Health Business Solutions LLCSenior Manager, Clinical and CodingCooper City, FLRemoteThe Senior Manager will provide leadership to multidisciplinary audit teams, support complex audit responses, analyze trends, and partner with internal and external stakeholders to mitigate risk and improve documentation, coding, and reimbursement practices. Health Business Solutions (HBiz) is seeking an experienced and strategic Senior Manager, Clinical & Coding to lead and oversee clinical and coding operations across government and commercial payers, including post-pay audit.
Perinatal Nurse Navigator HCA Healthcare IncPerinatal Nurse NavigatorMargate, FLRemoteEnsures the patient is empowered to manage his/her healthcare needs Provides healthcare system guidance and promotes adherence to recommended treatment throughout the care pathway Supports providers by assisting patients and/or families in understanding their diagnosis, treatment options, and the resources available, including education, clinical research studies (as applicable), and technological advances Provides education/connection to community and external resources, such as access to supportive care, financial support, and return to work Streamlines process for patients by assisting with appointment scheduling in a compliant manner Ensures the organization of appointments and explains the sequence of treatments Ensures smooth transitions between care modalities, facilities, and providers Facilitates patient movement through the appropriate clinical pathway and collaborates with physicians to ensure patient compliance Reinforces patient-specific teaching as defined by the patients provider Conducts follow-up conversations with patients and communicates any concerns, changes, or social needs to the appropriate physician or other care provider Attends and participates in Multidisciplinary Meetings (MDM) and/or other care planning conferences, as required by the navigation program Ensures appropriate patient data is available, including assessment and documentation Educates the patient and family regarding planned procedures, medications, and treatments What you will need in this role: 1-3 years of experience in Nursing Required 3+ years of experience as a Nurse Navigator and/or patient educator in service line Preferred Education Associates Degree in Nursing required Bachelors Degree in Nursing preferred Licenses and Certifications Basic Cardiac Life Support (preferred if remote position) Required Registered Nurse - Currently licensed as a registered professional nurse in the state in which he or she practices, in accordance with law and regulation. What you will do in this role: Serves as a patient advocate Assesses the patients medical and psychosocial needs as they pertain to their primary medical or surgical condition for navigation Uses appropriate tools to identify patient needs and barriers to care and provides access to potential resolutions Identifies health disparities and assists in the removal of these disparities Provides appropriate education, outreach, and support to patients and families.
New Business Development – Nursing Home & Assisted Living - Remote Transformational Health Network, Inc.New Business Development – Nursing Home & Assisted Living - RemoteMiami, FLRemoteAt Transformational Health Network, Inc. (TrHN), we partner with respected healthcare organizations to place highly skilled registered nurses, advanced practice providers, and physicians in roles where they can make a meaningful impact on patient care. The ideal candidate has experience in healthcare sales, business development, account management, or senior care services and is passionate about helping healthcare organizations meet their staffing and patient care needs.
NewSr. Quality of Care Review Nurse Oscar HealthSr. Quality of Care Review NurseMiami, FLRemote$83,628–$109,761.75 / yearClinical Quality programs are designed to enhance clinical outcomes and concierge-level service to our members, through review of services provided to members from network healthcare providers, facilities and Oscar employees. Experience in healthcare quality assurance, including experience auditing medical records and evaluating clinical information and internal documentation to determine the quality of care and service provided to members.
Second Level Reviewer I PRN Remote AdventHealthSecond Level Reviewer I PRN RemoteAltamonte Springs, FLRemote$31.82–$59.17 / hourAdditional Information: An equivalent combination of education and relevant work experience may be considered in lieu of the stated degree requirement:- BSN and 3+ years of Clinical Documentation Specialist experience OR - 4+ years of Clinical Documentation Specialist experience OR - Less than 2 years of Clinical Documentation Integrity experience and 10 years of acute care nursing experience. Initiates and formulates CDI severity worksheets and clinically credible clarifications for inpatients, presenting opportunities for improved documentation compliance to physicians, nurse practitioners, and other clinical team members.