- Bristol Myers Squibb (Tampa, FL)
- …for strategic and functional leadership of a team responsible for accurate and timely Managed Care Commercial and Medicare Part D rebate processing and payments, ... as well as all aspects with evaluating implications of and reporting Managed Care data required for US and Puerto Rico government pricing calculations.… more
- University of Miami (Medley, FL)
- …. The Department of Business Development and Managed Care is currently seeking an Executive Director , Managed ... work at our offices in Medley, Florida. The Executive Director , Managed Care Operations develops,...including JCAHO, AHCA, CMS, etc. Reporting to the UHealth Associate Vice President of Managed Care… more
- Humana (Tallahassee, FL)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with...size of region or line of business. The Medical Director conducts Utilization Management of the care … more
- AdventHealth (Orlando, FL)
- …and capacity to think strategically and implement tactically + Well versed in managed care and health policy + Experience with healthcare informatics, electronic ... of clinical strategies that align with the organization's goals for quality care , patient safety and operational efficiency + Collaborate with physicians, nurses and… more
- Humana (Tallahassee, FL)
- …services (such as inpatient rehabilitation). **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... management. The clinical scenarios arise from outpatient, inpatient or post-acute care environments. The Medical Director will have discussions with external… more
- Humana (Tallahassee, FL)
- …Qualifications** + **Knowledgeable in hematology and oncology** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid ... a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with...size of region or line of business. The Medical Director conducts Utilization Management of the care … more
- Humana (Tallahassee, FL)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with...size of team or line of business. The Medical Director conducts Utilization Management of the care … more
- Humana (Tallahassee, FL)
- …+ 5 years of established, post-residency clinical experience + Knowledge of the managed care industry including Medicare, Medicaid and/or Commercial products + ... our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals.… more
- Compass Group, North America (Belle Glade, FL)
- …17,000 professional food service team members. Job Summary Job Summary: The Chef/ Director of Dining Services is an exciting opportunity for an energetic, ... responsible for the successful operation of Dining Services. The Director ensures client, customer service/satisfaction with efficient cost effective management… more
- Humana (Tallahassee, FL)
- …skills + 5 years of established clinical experience + Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products + ... 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… more
- Evolent (Tallahassee, FL)
- …people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care ... system and ensure people get the same level of care and compassion we would want for our loved...as we solve complex business problems. **Collaboration Opportunities:** The Director , Actuarial Services utilizes and develops analytical tools to… more
- University of Florida (Jacksonville, FL)
- …and Critical Care Medicine Programs to community physicians and managed care organizations. + Participate in monthly division meetings, administrative ... Emergency Medicine/Critical Care Physician & Clinical Assistant/ Associate Professor...Emergency Medicine. This position will report to the Medical Director at the assigned site and Chairman of the… more
- Molina Healthcare (FL)
- …DRG/RCC pricing). 2 years supervisory/management experience with appeals/grievance processing within a managed care setting. To all current Molina employees: If ... to Molina Medicare's maximum STAR ratings.. **Job Qualifications** **Required Education** Associate 's Degree or 4 years of Medicare grievance and appeals experience.… more
- Mass Markets (FL)
- …highly motivated and dedicated and should possess the below qualities: + Associate 's or Bachelor's degree in Business Administration, Operations Management, or a ... applicant on the basis of age, ancestry, color, family or medical care leave, gender identity or expression, genetic information, marital status, medical condition,… more
- University of Florida (Jacksonville, FL)
- …Assist in marketing the Vascular Surgery Programs to community physicians and managed care organizations. + Participate in monthly division meetings, ... Vascular Surgeon & Clinical Assistant/ Associate Professor/Full Professor Apply now (https://secure.dc4.pageuppeople.com/apply/674/gateway/default.aspx?c=apply&lJobID=535334&lJobSourceTypeID=796&sLanguage=en-us) Job no:… more
- ChenMed (North Miami Beach, FL)
- …the Commission for Case Manager Certification (CCMC) or the American Association of Managed Care Nurses (CMCN) desired. We're ChenMed and we're transforming ... your kindness and joy? We're different than most primary care providers. We're rapidly expanding and we need great...facilities. + In conjunction with the PCP, Hospitalist, Medical Director , insurance case manager and the hospital case manager,… more
- ChenMed (Tampa, FL)
- …and linguistically diverse setting is essential + Experience working within a managed care environment strongly preferred We're ChenMed and we're transforming ... your kindness and joy? We're different than most primary care providers. We're rapidly expanding and we need great...the scope and member volume. + Assists the Medical Director , Cardiology in managing the day-to-day clinical and business… more
- CenterWell (Winter Haven, FL)
- …implements, analyzes, and organizes clinical operations for a specific location managed . + Conducts/delegates the assessment and reassessment of patients, including ... updating of care plans and interpreting patient needs, while adhering to...outcome planning. + Works in conjunction with the Branch Director and Company Finance Department to establish location's revenue… more
- MyFlorida (Pensacola, FL)
- …the Public Health Services Manager E - SES and the Health Medical Executive Director - SES regarding HIV/AIDS expenses and the development of spending plans. State ... of current legislation, activities trends and funding sources relative to HIV care . Ensure that all relevant HIV/AIDS, contracts, MOAs, and MOUs (responsibility of… more
- University of Florida (Gainesville, FL)
- …and communities. The chair collaborates with the Senior Vice President, Deans, Associate and Assistant Deans, other IFAS Chairs and Research and Education Center ... Environment is an interdisciplinary unit housed in IFAS and managed by several colleges on campus. UF/IFAS employs nearly...Agricultural and Life Sciences, the Dean for Extension and Director of the Florida Cooperative Extension Service, the Dean… more