• Medical Director -- Claims

    Humana (Tallahassee, FL)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
    Humana (10/29/24)
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  • Director - Complex Claims

    Sedgwick (Miami, FL)
    …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Director - Complex Claims **PRIMARY PURPOSE** **:** To be responsible for ... negotiation, mediation, arbitration, or ADR skills on higher value complex claims . Management experience preferred. Specific jurisdictional expertise required.… more
    Sedgwick (12/17/24)
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  • Casualty Claims Manager - Remote…

    GuideOne Insurance (Tampa, FL)
    …etc.), submits monthly reports detailing unit activity and results to line of business director and senior claims management as requested. + Responsible for ... to use commonly-used concepts, practices and procedures within the claims and management fields. + Complete formal...and AD&D, long-term disability and short-term disability insurance + Medical , dental and vision plans to meet your unique… more
    GuideOne Insurance (01/04/25)
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  • Medical Director - Florida

    Humana (Tallahassee, FL)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
    Humana (12/14/24)
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  • Medical Director - National Medicare…

    Humana (Tallahassee, FL)
    management or utilization management . **Additional Information** Reports to a Lead Medical Director . The Medical Director conducts Utilization ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests… more
    Humana (11/08/24)
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  • Director of Ambulatory Services Risk…

    AdventHealth (Ormond Beach, FL)
    …policies and procedures. The Director manages the Ambulatory Services Risk Management & Patient Safety Department and the Medical staff department. The ... Dr, Ormond Beach, 32174 **The role you'll contribute:** The Director of Ambulatory Services Risk Management &... Director will also provide support to the Medical Executive Council and other governance committees. Actively participates… more
    AdventHealth (11/16/24)
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  • Director , Medical Affairs - NYC…

    Merck (Tallahassee, FL)
    **Job Description** **Role Summary** The Regional Medical Scientific Director is a credentialed (ie, PhD, PharmD, DNP, MD) therapeutic and disease expert who ... SLs, including questions about Company products. The work of an Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific… more
    Merck (12/19/24)
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  • Director , Consumer Service Operations

    Humana (Tallahassee, FL)
    …of our dynamic Wisconsin leadership team in this position as the Director , Consumer Service Operations. This position works with insurance companies, providers, ... members, and collection services in the settlement of claims through Call Center operations. Comprised of a team of claims associates researching & resolving the… more
    Humana (01/01/25)
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  • Director , Risk Management

    Western Digital (Tallahassee, FL)
    …of action. + Develop, formulate and coordinate property and casualty insurance claims control function at all locations. + Continue review of existing safety, ... environment, loss prevention, employment and security programs as related to the management of risk or accidental loss. + Maintain historical record of all losses,… more
    Western Digital (12/27/24)
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  • Medical Director

    Molina Healthcare (FL)
    …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
    Molina Healthcare (12/26/24)
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  • Medicare Grievances and Appeals Corporate…

    Humana (Tallahassee, FL)
    …help us put health first** The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director ... of diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the… more
    Humana (01/07/25)
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  • AdventHealth West Florida Division Women's…

    AdventHealth (Tampa, FL)
    **Overview** AdventHealth West Florida Division Women's Services Institute is seeking a Medical Director . The director 's medical specialty can be OB/Gyn, ... AHMG Leadership in its investigation of patient complaints and/or claims related to the stated practices + Advise AHMG...management and resolution of complaints from patients and Medical Staff; + Make or direct the making of… more
    AdventHealth (12/14/24)
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  • Director of Physical Plant

    Florida Atlantic University (Boca Raton, FL)
    …issues are corrected (ie trip hazard, concrete cracks, etc.). Work closely with Risk Management when claims due to failed applicable PP systems happen. This ... their existing Workday employee account. Position Summary: Florida Atlantic University is seeking a Director of Physical Plant - Boca Raton, FL. The Director of… more
    Florida Atlantic University (12/13/24)
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  • Director of International, Global Household…

    HomeSafe Alliance (Jacksonville, FL)
    **Title:** Director of International, Global Household Goods Moving Services **_HomeSafe Alliance_** is the single global household goods movement manager of over ... the Role** HomeSafe Alliance is seeking a highly skilled and motivated Director of International, Household Goods Moving Services to drive optimization and improve… more
    HomeSafe Alliance (12/21/24)
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  • CE Strategic SCM Director 1

    Celestica (Orlando, FL)
    …**Functional Area:** Supply Chain Management (SCM) **Career Stream:** Supply Chain Management (SCM) **Role:** Director 1 (DR1) **Job Title:** Director , ... a dynamic market environment. **Detailed Description** We are currently seeking a ** Director , Strategic Supply Chain Management (Capital Equipment)** to join our… more
    Celestica (12/20/24)
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  • Director of Quality

    Brunswick (Edgewater, FL)
    …will help transform vision into reality:** Position Overview: The Boston Whaler Director of Quality will be responsible for developing and implementing quality ... culture of quality and continuous improvement throughout the organization. The Quality Director will be responsible for both internal and external quality metrics… more
    Brunswick (11/06/24)
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  • Director Healthcare Economics & Trend…

    Baylor Scott & White Health (Tallahassee, FL)
    claims data to uncover trends and assist in managing and understanding incurred medical and pharmacy cost. - The Director will design, develop, and support ... **Position Overview:** Reporting to the VP, Value-based Care Analytics, the Director of Healthcare Economics and Trend Analytics will support the Baylor Scott &… more
    Baylor Scott & White Health (12/21/24)
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  • Deputy Director of Construction (Aviation)

    Jacobs (Tampa, FL)
    …the Client. You'll provide input and analysis as needed to support client claims management . You'll liaise with internal and external airport stakeholders during ... Our onsite Program Management team in Tampa, FL is looking to...is looking to add an experienced and collaborative Deputy Director of Construction to support Master Plan projects at… more
    Jacobs (12/28/24)
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  • Associate Director , Pharmacy…

    ChenMed (Miami, FL)
    …expanding and we need great people to join our team. The Associate Director of Pharmacy & Dispensing is responsible for the operation of the Dispensing/Pharmacy ... program for ChenMed, et. al Medical Centers. This position is also responsible for execution...for execution and implementing policies and procedures. The Associate Director , Pharmacy communicates effectively with providers and staff, makes… more
    ChenMed (01/07/25)
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  • Actuarial Director , Medicaid Trend…

    Humana (Tallahassee, FL)
    …our caring community and help us put health first** The Actuarial Director , Analytics/Forecasting analyzes and forecasts financial, economic, and other data to ... short, medium and long-term financial and competitive position. The Director , Actuarial Analytics/Forecasting requires an in-depth understanding of how organization… more
    Humana (01/03/25)
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