Remote Risk Adjustment Coding Jobs in Hialeah, FL

Remote Pediatric Case Manager Role!

Job Description

The Pediatric Case Manager plays a crucial role in managing complex and chronic conditions within a pediatric population in a managed care environment. This position collaborates with providers, hospitals, and multidisciplinary teams to coordinate care, close gaps, and enhance health outcomes while minimizing avoidable utilization.

Responsibilities

• Conduct comprehensive needs assessments and stratify risk.
• Develop individualized care plans aligned with evidence-based guidelines.
• Review inpatient census activity and coordinate discharges.
• Conduct outreach to high-risk members and provide disease-specific education.
• Empower patients and families in self-management.
• Operate in compliance with Medicaid requirements and PCMH standards.
• Support cost-effective care delivery and improve members' quality of life.

Essential Skills

• Active Florida RN license.
• Bachelor’s Degree in Nursing (BSN required; MSN preferred).
• 3–5 years of clinical nursing experience.
• Hands-on case management experience, preferably within managed care or population health.
• Pediatric (PED) or PICU clinical experience supporting medically complex populations.

INTERESTED IN THIS ROLE? SEE BELOW TO BE IMMEDIATELY CONSIDERED:

• I am scheduling phone interviews as early as today. All candidates will be considered immediately within 24 hours of applying directly to Fathima
• HOW TO APPLY DIRECTLY: Email your updated resume, brief intro about your interest, preferred method of communication for you (i.e., call, email, text) to fam@actalentservices.com or CALL- 904 530 5415

Job Type & Location

This is a Contract position based out of Sunrise, FL.

The pay range for this position is $40.00 - $44.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:
• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

This is a hybrid position in Sunrise,FL.

This position is anticipated to close on Jun 30, 2026.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. We are proud to be an Engineering News-Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffing® winner for both client and talent service.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.