- CVS Health (Tallahassee, FL)
- …the full continuum of our members' health care and social determinant needs. The Case Management (CM) Medical Director will participate in designing, ... 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… 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)
- **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
- Humana (Tallahassee, FL)
- …of Agreements, coding practices, Clinical Integration, Long Term Services & Supports, and Case Management. The Medical Director , as indicated, could need ... 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
- 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
- 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...clinical services . Experience in utilization management review and case management in a health plan setting . No… 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, ... policy and protocol, case studies, and disseminates best in class knowledge. The...studies, and disseminates best in class knowledge. The Associate Director requires a solid understanding of how organization capabilities… more
- HCA Healthcare (Tallahassee, FL)
- …the needs of each Rehab patient. The CM collaborates with the Rehab Program Director and Facility Case Management Director regarding departmental functions. ... an organization that invests in you as a(an) RN Case Manager PRN? At HCA Florida Capital Hospital, you...colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no… more
- HCA Healthcare (Tallahassee, FL)
- …the needs of each Rehab patient. The CM collaborates with the Rehab Program Director and Facility Case Management Director regarding departmental functions. ... Do you have the career opportunities as a(an) RN Case Manager you want in your current role? We...colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no… more
- Highmark Health (Tallahassee, FL)
- …overall efficiencies. + Manage individual projects for timely review with the Director , Clinical Pharmacy. + Participate in Medicare Stars performance measures ... the incumbent may also review UM requests; provide consultation into the case and disease management identification process, and consult with the Organization's… more