• Medicare Medical Director

    Elevance Health (Tampa, FL)
    ** Medicare Medical Director ** Location: This position will work a hybrid model (remote and office). The ideal candidate will must live within 50 miles of one ... Candidates must be able to work Eastern Time Zone hours. The ** Medicare Medical Director ** is responsible for the administration of physical and/or… more
    Elevance Health (01/08/25)
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  • Medical Director

    Molina Healthcare (St. Petersburg, FL)
    …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
    Molina Healthcare (01/13/25)
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  • Associate Market Clinical Director

    ChenMed (Largo, FL)
    …preferred. + Strongly prefer one (1) years' previous experience as Medical Director or equivalent with a Medicare or Medicaid patient population + Board ... preferred. + Preferred to be an existing high performing PCP partner and/or Medical Director within the ChenMed core model, with a proven ability to manage a… more
    ChenMed (11/09/24)
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  • Executive Director of Quality

    AdventHealth (Tampa, FL)
    …six story surgical and patient care tower which will ensure state of the art medical and surgical car for generations to come . Awarded the Get With The Guidelines ... as a Primary Stroke Center. **The role you'll contribute:** The Executive Director will be responsible for: . Leading, planning, directing and coordinating the… more
    AdventHealth (01/03/25)
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  • Director , SIU / Fraud Waste and Abuse…

    Molina Healthcare (St. Petersburg, FL)
    …Access, Word and Excel * Knowledge and understanding of claims processing systems and medical claims * Knowledge of HMO, PPO, POS, MCO, Medicare , Medicaid, ... Market Place products, laws, rules and regulations **Preferred Education** * Master's degree **Preferred Experience** * Formalized training/experience in Health Care Insurance Fraud * Experience with Power BI, SAS, SQL other reporting software * ICD-10 CPT-4,… more
    Molina Healthcare (01/13/25)
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  • RN Clinical Manager Home Health Full Time

    CenterWell (Clearwater, FL)
    …audits/billing are completed timely and in compliance with Medicare regulations. + Coordinates communication between team members/attending physicians/caregivers ... of care and outcome planning. + Works in conjunction with the Branch Director and Company Finance Department to establish location's revenue and budget goals. +… more
    CenterWell (10/30/24)
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  • Pharmacist, Clinical/MTM

    Molina Healthcare (St. Petersburg, FL)
    …therapeutic drug monitoring, drug regimen review, patient education, and medical staff interaction), and oversight (establishing and measuring performance metrics ... + Provides medication therapy management including examination of member medical records, performing a comprehensive medication review, and communicating with… more
    Molina Healthcare (01/13/25)
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  • Home Health Account Sales Representative

    HCA Healthcare (Largo, FL)
    …and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low ... health coverage as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision benefits, life and… more
    HCA Healthcare (11/23/24)
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  • Clinical Education Coordinator

    HCA Healthcare (St. Petersburg, FL)
    …and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low ... health coverage as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision benefits, life and… more
    HCA Healthcare (01/07/25)
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  • Program Manager (GUIDE Model), LSW or RN

    Bluestone Physician Services (Tampa, FL)
    …an evidence-based approach focused on quality care management and data-driven medical decisions, Bluestone care teams collaborate to manage patients' chronic ... (ACO) was the best performing ACO in the country (https://bluestonemd.com/2023/09/bluestone-aco-delivers-excellent-care-to-medically-complex-elderly-patients-saves- medicare -26-6-million/) as measured by the overall savings per … more
    Bluestone Physician Services (12/22/24)
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