- Humana (Tallahassee, FL)
- …or data requires an in-depth evaluation of variable factors. The Medical Director for the National Medicare Outpatient Team provides medical ... caring community and help us put health first** The Medical Director relies on medical ...Prefer Medicaid experience + Utilization management experience in a medical management review organization, such as Medicare … more
- CVS Health (Tallahassee, FL)
- …(work at home) based anywhere in the US.** Responsibilities of this Medical Director role are related to Regulated Medicare Appeals: * Direct daily work on ... 6 company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity...* Board Certified in ABMS Recognized Specialty **Preferred Qualifications** Medical Management - Medicare Complaints, Grievance &… more
- CVS Health (Tallahassee, FL)
- …our members' health care and social determinant needs. The Case Management (CM) Medical Director will participate in designing, developing and deploying our ... reside in Florida and and must have a Florida medical license or be willing to obtain one. **Primary...business needs * 3-5 years of Managed Care experience; Medicare highly preferred * 3-5 year of Case Management… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Tallahassee, FL)
- …determinations, clinical reference materials, internal teaching conferences, and other reference sources. Medical Director will learn National LTSS State ... community and help us put health first** The Long-term services and supports (LTSS) Medical Director 's primary responsibility is the review of medical … more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...group practice management. + Utilization management experience in a medical management review organization, such as Medicare … more
- Evolent (Tallahassee, FL)
- …the mission. Stay for the culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Evolent (Tallahassee, FL)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Molina Healthcare (Jacksonville, FL)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... staff services. Maintains a working knowledge of applicable national , state, and local laws and regulatory requirements affecting...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Humana (Tallahassee, FL)
- …our caring community and help us put health first** The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The ... Behavioral Health Medical Director work assignments involve moderately complex...compliance and assisted by diverse resources, which may include national clinical guidelines, state policies, CMS policies and determinations,… more
- AdventHealth (Orlando, FL)
- …care fellows and new staff along with community outreach; and program development. + The medical director would also be involved with building a core team of ... This leadership position would report directly to the Executive Medical Director of AHMG Critical Care and...a leading provider of cardiovascular and thoracic services among Medicare patients with national rankings that include:… more
- Evolent (Tallahassee, FL)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , Genetic Testing you will be a key member of the utilization ... recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management… more
- Aveanna Healthcare (West Palm Beach, FL)
- Facility Director (RN) - Pediatric Medical Day Care Center ApplyRefer a FriendBack Job Details Requisition #: 203453 Location: West Palm Beach, FL 33411 ... Nursing Salary: Starting at $75,000.00 per year Position Details Pediatric Location Director - RN (Registered Nurse) Work Location:2005 Vista Parkway, Suite 110A,… more
- CVS Health (Plantation, FL)
- …workflows to enhance accuracy and productivity. * Collaborate closely with the SIU Medical Director to align coding practices with organizational goals. * Work ... care more personal, convenient and affordable. **Position Summary:** As the Coding Director , you will oversee the coding operations, ensuring accurate and efficient… more
- Evolent (Tallahassee, FL)
- …for the mission. Stay for the culture. **What You'll Be Doing:** **Associate Medical Director - Cardiovascular Medicine (Cardiologist) | Evolent Health** Are you ... to drive meaningful change beyond the bedside? Evolent Health is seeking an **Associate Medical Director - Cardiovascular Medicine** to play a critical role in… more
- Elevance Health (Tampa, FL)
- ** Director II Medical Management** **Location:** This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles from ... either the Tampa or Miami Elevance Health PulsePoint office locations. The ** Director II of Medical Management** is responsible for managing an environment of… more
- Humana (Tallahassee, FL)
- …our caring community and help us put health first** The Associate Director - Value-based Specialty and Vendor Support role builds templates, standard documentation, ... case studies, and disseminates best in class knowledge. The Associate Director requires a solid understanding of how organization capabilities interrelate across… more
- Genesis Healthcare (Tavares, FL)
- …Powerback is the place for you. **Why Powerback?** + **Benefits:** We offer Medical , Dental, and Vision plans to Full-Time and Part-Time team members. + **Support ... expertise with our Clinicians in Action professional development program. Responsibilities The Director of Rehab OT is responsible for the efficient management of… more
- NASCO (Tallahassee, FL)
- **Overview** As Executive Director , Compliance you will lead and provide oversight and management of Compliance and Privacy functions and serve as the company's ... Compliance Office. This role will have oversight responsibility for Medicare Advantage and ACA Exchanges strategy and executive relationship responsibility… more
- AdventHealth (Tampa, FL)
- **Basic Function** The Fellowship Program Director , in accordance with the specific accreditation body, has responsibility and accountability for the operation of ... well-being. + Oversight of scholarly activities The Fellowship Program Director reports to the Sponsoring Institution's Chief Academic Officer/Designated… more