• 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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  • 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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  • Remote Behavioral Medical Director

    Centene Corporation (Tallahassee, FL)
    …the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit. + ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a...performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals… more
    Centene Corporation (11/06/24)
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  • Medicare Grievances and Appeals Corporate…

    Humana (Tallahassee, FL)
    …us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate ... Medical Director works on problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with… more
    Humana (10/29/24)
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  • Director , Network Operations

    Sedgwick (Tallahassee, FL)
    …+ Establishes policy and procedures to assure compliance to best practices, claims management services standards, state regulations, and client service ... work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Director , Network Operations **PRIMARY PURPOSE** : To be responsible for the… more
    Sedgwick (11/16/24)
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  • Associate Director , Access and Patient…

    Cardinal Health (Tallahassee, FL)
    …are used. **What this position contributes to Cardinal Health:** The Associate Director , Access and Patient Support (APS) is responsible for the tactical execution ... collaboration and integration with cross functional teams. The Associate Director oversees revenue and budget accountability, organizational development, and… more
    Cardinal Health (11/14/24)
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  • Client Services Director - Casualty | CST…

    Sedgwick (Tallahassee, FL)
    …rounding ability + Strong understanding of workers compensation, liability and disability claims management + In-depth knowledge of client servicing + Ability ... Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Client Services Director - Casualty | CST & EST Time Zones...EST Time Zones **PRIMARY PURPOSE** : To determine account management strategies related to client service plans; to be… more
    Sedgwick (11/12/24)
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  • Associate Director , Global Labeling Lead…

    Takeda Pharmaceuticals (Tallahassee, FL)
    …to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director , Global Labeling Lead where you will be responsible for the development ... guidance. **How you will contribute:** With guidance from leadership: Management of Labeling Cross-Functional Teams + Independently leads Labeling cross-functional… more
    Takeda Pharmaceuticals (10/16/24)
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  • Director Marketing Campaign Strategy…

    Sedgwick (Tallahassee, FL)
    …Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Director Marketing Campaign Strategy and Execution **PRIMARY PURPOSE OF THE ROLE:** ... The Director , Marketing Campaign Strategy and Execution is responsible for...improve client satisfaction. **QUALIFICATIONS** + 8+ years B2B Campaign Management leadership experience. + Solid experience with campaign technologies… more
    Sedgwick (10/31/24)
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  • Lead Director , Operations - CVS…

    CVS Health (Tallahassee, FL)
    …health care more personal, convenient and affordable. **Position Summary:** **The Lead Director , Operations (hiring for two positions)** plays a key role by leading ... executive, providers, and administrative staff. + Relationship building + Medical cost, risk, and quality analysis + Transforming data...in a care delivery setting, population health and care management + 5+ years of strong Medicare and clinical… more
    CVS Health (10/27/24)
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  • Coordinator, Intake Utilization Management

    Evolent Health (Tallahassee, FL)
    …Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for processing ... medical treatment requests in accordance with departmental policies, regulatory...contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, Intake Utilization … more
    Evolent Health (11/12/24)
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  • Administrative Assistant (Hybrid Role…

    Kepro (Tallahassee, FL)
    …minimal disruption. + Act as the primary liaison between peer reviewers, the Medical Director , and additional team members, facilitating clear and constructive ... organization, your contribution will be pivotal in the precise management of our claims tracking system. Your...and communicate effectively with the team and supervisors. + Medical terminology knowledge is beneficial but not mandatory. +… more
    Kepro (11/13/24)
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  • Medical /Health Care Program Analyst

    MyFlorida (Tallahassee, FL)
    68064844 - MEDICAL /HEALTH CARE PROGRAM ANALYST Date: Nov 12, 2024 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... 837912 Agency: Agency for Health Care Administration Working Title: 68064844 - MEDICAL /HEALTH CARE PROGRAM ANALYST Pay Plan: Career Service Position Number: 68064844… more
    MyFlorida (11/12/24)
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  • Cloud Solutions Architect Leader

    Sedgwick (Tallahassee, FL)
    …and goals for cloud-based infrastructure services in conjunction with senior IT management . The Director Infrastructure Services - Cloud designs and drives ... This role is responsible for the overall planning and management of the company data center and corporate IT...benefits package is offered including but not limited to, medical , dental, vision, 401k and matching, PTO, disability and… more
    Sedgwick (10/18/24)
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  • Government Operations Consultant III

    MyFlorida (Tallahassee, FL)
    …the operations of the Medicaid fiscal agent, including Medicaid claims process, billing procedures, reimbursement methodologies, encounter submissions, and provider ... Medicaid policies, national Medicaid-related research and demonstration projects, Medicaid medical assistance program innovations for general and special populations,… more
    MyFlorida (10/18/24)
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  • Senior Compliance Specialist

    Fujifilm (Tallahassee, FL)
    …limited management oversight. The position will report to the Director of Corporate Compliance. **Duties and responsibilities** + Develop and implement elements ... needs of healthcare across prevention, diagnosis, and treatment. Fujifilm's medical imaging portfolio includes solutions for digital radiography, mammography,… more
    Fujifilm (10/09/24)
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