- Humana (Tallahassee, FL)
- …of our caring community and help us put health first** The Clinical Pharmacy Provider Engagement Associate Director , HPS Clinical Program Strategy, partners with ... and identify new opportunities to further PBM goals around quality , Stars, pharmacy trend, and CenterWell ...improvement and opportunity + Act as a clinical pharmacy thought leader among Humana's network of providers and… more
- Prime Therapeutics (Tallahassee, FL)
- …drives every decision we make. **Job Posting Title** Manager Rebate Pharmacy Operations **Job Description Summary** This position provides administrative oversight ... direct reports attendance and reliability patterns. + Administers performance improvement or corrective action plans when needed for direct...auditors for yearly SOC-1 audit. + Works directly with Director to fulfill OIG and CMS audit requests. +… more
- Centene Corporation (Tallahassee, FL)
- …the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. + Provides ... leadership of all for utilization management, cost containment, and medical quality improvement activities. + Performs medical review activities pertaining… more
- Prime Therapeutics (Tallahassee, FL)
- …product domain + Monitor the performance of clinical products and implement continuous quality improvement plans to ensure the outcome improves cost and ... decision we make. **Job Posting Title** Clinical Program Development Director , Stars - Remote **Job Description** The Clinical Program...quality of care and assures regulatory compliance + Manage… more
- CenterWell (Tallahassee, FL)
- …+ Establish relationship with post-visit/offshore coding leadership. + Develop continuous quality improvement initiatives to support improved documentation and ... of our caring community and help us put health first** The Associate Director , Risk Adjustment oversees quality assurance audits of medical records, ICD-10-CM,… more
- Humana (Tallahassee, FL)
- …health first** Humana's Marketing organization is seeking a dynamic and experienced Director , Campaign Planning & Orchestration Leader to join our team. This leader ... reports directly to the VP of Pharmacy Marketing and is responsible for driving the design...and developing high-performing teams, fostering a culture of continuous improvement and accountability. **Key Role Functions** + Oversees the… more
- Prime Therapeutics (Tallahassee, FL)
- …our passion and drives every decision we make. **Job Posting Title** Sr. Director Government Programs Product Solutions **Job Description** The Senior Director ... the product portfolio + Formulate and execute process and organizational improvement , direction, and programs to enhance overall effectiveness; proactively seek ways… more
- Option Care Health (Tallahassee, FL)
- …state and federal guidelines for disciplines. Serves as office administrator with the pharmacy manager in the absence of the Sr./ Director , Operations. Serves as ... Manager of Nursing enforces and ensures that a total quality management program for all aspects of patient care...all patient care and services in cooperation with the Director of Pharmacy . Facilitates a clinical networking… more
- CenterWell (Tallahassee, FL)
- …to the Director , highlighting areas of success and opportunities for improvement . + Assist Director with performance management activities such as but ... The Clinical Strategy and Practice Lead directly supports the Director of Clinical Strategy and Practice in building strategies...multi-task in a fast-paced work environment + Understanding of quality and value drivers in full risk care delivery,… more
- Prime Therapeutics (Tallahassee, FL)
- …written responses to proposal questions using the established criteria for quality proposal responses; partner with stakeholders to ensure inclusion of strategic ... Formulary, Underwriting and other departments to drive RFP process and response improvement to help promote company-wide understanding and adherence to the RFP… more
- Prime Therapeutics (Tallahassee, FL)
- …a variety of complex problems + Drive enterprise-wide transformation and process improvement to financial pricing analytics processes and programs + Other duties as ... financial analysis to include 5 years of experience in Pharmacy Benefit Management (PBM), claims processing, healthcare, and/or related...ability to adjust focus **Reporting Structure** + Reports to Director or Senior Director in the Network… more
- Prime Therapeutics (Tallahassee, FL)
- …business partners with regard to related regulatory activity and quality efforts involving utilization and/or medication therapy management, network management, ... related to audit or compliance review findings, and recommend ideas for improvement and summarize action plans + Other duties as assigned **Required Qualifications**… more
- Prime Therapeutics (Tallahassee, FL)
- …experience in legal or compliance related roles for a healthcare or Pharmacy Benefit Management organization, or within a highly regulated industry, including ... and/or Health Insurance Marketplace guidance + Experience identifying opportunities for improvement and leading the implementation of process changes. + Strong… more