We interpreted Midway, FL as Midway, FL. Other options include: Midway (Seminole County), FL
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and ...to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of… more
- Humana (Tallahassee, FL)
- …our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. ... The Behavioral Health Medical Director work assignments involve moderately complex...conferences, and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare… more
- CVS Health (Tallahassee, FL)
- …based (work at home) based anywhere in the US.** Responsibilities of this Medical Director role are related to Medicare Appeals. * Direct daily work on part ... 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
- Humana (Tallahassee, FL)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and ... preservice appeals. The Corporate Medical Director reviews cases of diverse scope...experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and ...to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- CVS Health (Tallahassee, FL)
- …**Position Summary** CVS Health, a Fortune 4 company, has an outstanding opportunity for a Medical Director - Medical Affairs. We need a Board Certified ... clinical product development, Enterprise Analytics, Compliance, Legal, Accreditation) and clients. The Medical Director ( Medical Affairs) will report into… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- CenterWell (Tallahassee, FL)
- …under the PCO's Chief Medical Officer. This role reports to the National Director , High Risk Patient Management. Responsibilities will include: + Lead ... caring community and help us put health first** The National Director , Clinical Pharmacy is a strategic...and promote age-friendly care + Maintain current knowledge of pharmacy/ medical trends within ambulatory/primary care and Medicare … more
- CVS Health (Tallahassee, FL)
- …clinical coverage and policies. **Primary Job Duties & Responsibilities:** Behavioral Health Medical Director + Collaborates with health plan Sr Leadership to ... and services for aligned plan's members. Position Description: Aetna Medicare Duals Center of Excellence is searching for a...the delivery of holistic and integrated person-centered care. The Medical Director will be responsible for provider… more
- Conviva (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Director , Medical Coding extracts clinical information from a variety of medical ... and medical codes (eg, ICD-10-CM, CPT) to patient records. The Director , Medical Coding requires an in-depth understanding of how organization capabilities… more
- CenterWell (Tallahassee, FL)
- …The Associate Director , Risk Adjustment oversees quality assurance audits of medical records, ICD-10-CM, CPT, & HCPCS codes that are submitted to the Centers ... for Medicare and Medicaid Services (CMS), other payers, and over...payers, and over government agencies. In addition, the Associate Director , Risk Adjustment oversees all medical coding… more
- CVS Health (Tallahassee, FL)
- …health care more personal, convenient and affordable. **Position Summary** As the Director of Commercialization and Growth, part of the Health Care Delivery business ... a strong plus; particularly experience in Accountable Care Organizations (ACO), Medicare Shared Savings Program (MSSP), ACO REACH, or other value-based care… more
- Humana (Tallahassee, FL)
- …for the development, implementation, and management oversight of the company's Medicare /Medicaid Stars Program. The Associate Director , Stars Improvement, ... of how organization capabilities interrelate across department(s). The Associate Director , Stars Improvement, Clinical work focuses on areas of clinical… more
- HCA Healthcare (Tallahassee, FL)
- …This position is incentive eligible. **Introduction** The North Florida Division Director of Ambulatory Clinical Quality will serve as the lead subject ... and providers for HCA Physician Services Group. This Division Director of Ambulatory Clinical Quality provides oversight for the...not being met. + Provides education to employees and Medical Staff and supports ongoing education related to Quality… more
- Humana (Tallahassee, FL)
- …a part of our caring community and help us put health first** The Director , Actuarial of Medicaid Pricing provides actuarial support across a broad range of ... actuarial and business needs for specific product lines. The Director , Actuarial requires an in-depth understanding of how organization capabilities interrelate… more
- Prime Therapeutics (Tallahassee, FL)
- …legislative/oversight bodies (eg, URAC-Utilization Review Accreditation Commission, CMS-Centers for Medicare & Medicaid Services, NCQA- National Committee for ... passion and drives every decision we make. **Job Posting Title** Director , Specialty Clinical Solutions- RPH/PharmD required- REMOTE **Job Description Summary**… more
- Cardinal Health (Tallahassee, FL)
- …team is passionate about helping oncology practices navigate the future. The Director , Managed Care is responsible for strategy and management of managed care ... responsible to implement strategic initiatives related to payer contracts. The Director , Managed Care contributes to practice growth and profitability by providing… more
- Conviva (Tallahassee, FL)
- …Leaders to identify and influence enhancements to technology to improve the medical coder experience. + Oversees coding operations by identifying business partner ... of management experience + 8 or more years of Medical Coding, IPA, or similar experience + Medical...Ability to Travel **Preferred Qualifications** + Proven experience with Medicare Advantage risk adjustment functions. + Proven track record… more
- Humana (Tallahassee, FL)
- …providing frameworks to maximize available resources to achieve growth. The ** Director ,** **Medicaid Insurance Product Management and Wellness Strategy** will have ... your life extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan, time off (including… more