Top 1807 Director of care Jobs in Miami, Fl

Care Review Clinician (RN) - Remote in FL
Molina Healthcare, Inc. —Miami, FL
- $26.41 - $51.49 an hour
- Full-time
- Remote
- RN License
- Mid-level
- Critical & Intensive Care
- Health insurance
Care Review Clinician (RN) - Remote in FL
Molina Healthcare, Inc. —Florida
- $26.41 - $51.49 an hour
- Full-time
- Remote
- RN License
- Mid-level
- Critical & Intensive Care
- Health insurance
Clinical Operations Director RN, Hospice
AccentCare, Inc. —Plantation, FL
- $110,000 - $130,000 a year
- Monday to Friday
- Nursing
- Management
- RN License
- Mileage reimbursement
- Health savings account
Quick Apply
Director of Nursing Services
APEX Healthcare Staffing LLC —Miami, FL
- $140,000 - $150,000 a year
- Full-time
- Skilled nursing facility
- RN License
- Team management
- Paid holidays
- Health insurance
Quick Apply
Regional Director of Clinical Services RN - Central & Southwest Florida
Clear Choice Health Care —Florida
- Full-time
- Background check
- Nursing
- Anatomy knowledge
- Health insurance
- Dental insurance
Quick Apply
Director of Nursing (DON) – 3549405
Apex Healthcare —Miami, FL
- $150,000 - $175,000 a year
- Full-time
- Skilled nursing facility
- RN License
- Recruiting
Quick Apply
3d
Director Physician Practice Operations, Primary Care
Baptist Health Medical Group —Coral Gables, FL
- $133,831.04 - $173,980.35 a year
- Spanish
- 7 years
- Primary Care
- Wellness program
- Health insurance
Executive Director of Health and Human Services
Seminole Tribe of Florida —Hollywood, FL
- $350,000 - $500,000 a year
- Weekends as needed
- Doctoral degree
- Psychiatry
- Addiction Medicine
- Health savings account
- Health insurance
Quick Apply
Director of Wellness
The Barclay at ParkSquare —Aventura, FL
- $100,000 - $110,000 a year
- Weekends as needed
- CPR Certification
- Nursing
- Bachelor's degree
- Opportunities for advancement
Quick Apply
Assistant Executive Director
The Arbor Company —Miami, FL
- $100,000 a year
- Full-time
- Hospitality
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Dental insurance
Quick Apply
Regional Director, Field Patient Access (East)
Compass Pathways —Miami, FL
- $200,000 - $250,000 a year
- 5 years
- Bachelor's degree
- Travel
Quick Apply
Director of Facilities Management
HCA Florida Mercy Hospital —Miami, FL
- Full-time
- 1 year
- Senior level
- Employee stock purchase plan
- Disability insurance
Quick Apply
Director of Operations
CP DADELAND LLC —Miami, FL
- Bar
- Hotel
- Mentoring
- Disability insurance
- Health insurance
Quick Apply
Sr Manager, FOCUS
Gilead Sciences —Miami, FL
- $143,225 - $185,350 a year
- Full-time
- 6 years
- Residential
- Master's degree
- Health insurance
- Dental insurance
Branch Director, Home Health - Seattle, WA
Centerwell —Miami, FL
- $111,600 - $153,600 a year
- Full-time
- RN License
- Sales
- Physical & Rehabilitation Medicine
- Paid parental leave
- Paid holidays
Care Review Clinician, Specialty Therapist (Occupational / Physical / Speech) - REMOTE
Molina Healthcare —Miami, FL
- $26.41 - $51.49 an hour
- Full-time
- Remote
- Physical & Rehabilitation Medicine
- Mid-level
- Physical Therapy License
- Health insurance
10d
Regional Nurse Consultant (RN)
Florida Topaz SNF Group —Miami, FL
- Full-time
- Skilled nursing facility
- RN License
- 3 years
- Health insurance
- Dental insurance
Quick Apply
Director of Room Operations
Marriott International, Inc —Miami, FL
- $117,000 - $146,000 a year
- Full-time
- Hotel
- Bachelor's degree
- Business Administration
6d
HR Director, Southeast
Richemont —Miami, FL
- Full-time
- Travel
- Senior level
- Master of Business Administration
- Health insurance
- Dental insurance
10d
Associate Director of Customer Success (Remote)
UpsideHom, Inc. —Fort Lauderdale, FL
- $115,000 - $130,000 a year
- Full-time
- Remote
- 6 years
- Travel
- Senior level
- Paid holidays
- Health insurance
Quick Apply

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director of care jobs near miami, fl

Care Review Clinician (RN) - Remote in FL

Molina Healthcare, Inc. -
Miami, FL

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Job Details

Full-time
$26.41 - $51.49 an hour

Benefits

Health insurance

Qualifications

Inpatient experience
RN License
Managed care organization experience
Acute care facility experience
Pre-authorization review for utilization management
Productivity software

Full Job Description

JOB DESCRIPTION

Must reside in Florida

Job Summary

Provides support for clinical member services review assessment processes. Responsible 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. Contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

Assesses services for members to ensure optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines.
Analyzes clinical service requests from members or providers against evidence based clinical guidelines.
Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures.
Conducts reviews to determine prior authorization/financial responsibility for Molina and its members.
Processes requests within required timelines.
Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient manner.
Requests additional information from members or providers as needed.
Makes appropriate referrals to other clinical programs.
Collaborates with multidisciplinary teams to promote the Molina care model.
Adheres to utilization management (UM) policies and procedures.

Required Qualifications

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.
Registered Nurse (RN). License must be active and unrestricted in state of practice.
Ability to prioritize and manage multiple deadlines.
Excellent organizational, problem-solving and critical-thinking skills.
Strong written and verbal communication skills.
Microsoft Office suite/applicable software program(s) proficiency.

Preferred Qualifications

Certified Professional in Healthcare Management (CPHM).
Recent hospital experience in an intensive care unit (ICU) or emergency room.

Utilization Management (UM) experience highly preferred.

#PJHS3

#LI-AC1

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Apply Now

Refine Your Search

director of care jobs in miami, fl

Care Review Clinician (RN) - Remote in FL

Care Review Clinician (RN) - Remote in FL

Clinical Operations Director RN, Hospice

Director of Nursing Services

Regional Director of Clinical Services RN - Central & Southwest Florida

Director of Nursing (DON) – 3549405

Director Physician Practice Operations, Primary Care

Executive Director of Health and Human Services

Director of Wellness

Assistant Executive Director

Regional Director, Field Patient Access (East)

Director of Facilities Management

Director of Operations

Sr Manager, FOCUS

Branch Director, Home Health - Seattle, WA

Care Review Clinician, Specialty Therapist (Occupational / Physical / Speech) - REMOTE

Regional Nurse Consultant (RN)

Director of Room Operations

HR Director, Southeast

Associate Director of Customer Success (Remote)

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