- Molina Healthcare (St. Petersburg, FL)
- …3+ years HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization/Quality Program management + ... Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and… more
- CVS Health (Tallahassee, FL)
- …heart, each and every day. **Position Summary** Drive growth for Medicare Advantage External Distribution Partnerships by setting strategic sales goals, crafting ... winning strategies, and optimizing performance. Partner with senior leaders to deliver innovative solutions, streamline processes, and achieve measurable results.… more
- Molina Healthcare (FL)
- **JOB DESCRIPTION** **Job Summary** Responsible for analysis of Medicaid and Medicare financial reports, trend, and opportunities. Includes evaluation of and ... recommendations relating to business opportunities, Medicare bids, investments, financial regulations, and similar financial projects...early signs of trends or other issues related to medical care cost. + Design and perform actuarial studies… more
- Humana (Miami Lakes, FL)
- …of 8-12 Medicare Sales Agents, you'll work under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you'll ... of everything it does. The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role, and candidates must live… more
- Akumin (Miami, FL)
- Role is based in the Miami/Fort Lauderdale, FL area. Outpatient Imaging. The ** Senior ** ** Director of Operations** manages the daily operations, and planning the ... Requirements:** + High School Diploma or Equivalent Experience. + Previous medical industry experience required with outpatient imaging experience + Excel,… more
- CenterWell (Tallahassee, FL)
- …and high-risk Medicare patients within a full-risk, value-based framework. The Medical Director collaborates in a dyad partnership with the Strategy ... community and help us put health first** The National Medical Director for Home-Based Care Programs is...medical direction, clinical oversight, and advancement of CenterWell Senior Primary Care's (and Conviva Senior Primary… more
- CenterWell (Jacksonville, FL)
- …a part of our caring community and help us put health first** The Associate Medical Director (AMD) is an instrumental clinical leader of our primary care team, ... (clinical, financial, operational) meetings on key topics such as Medical Risk Adjustment (MRA), budgeting, staffing, operational excellence, and clinical… more
- Evolent (Tallahassee, FL)
- …Participates in on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to ... for utilization management while working in conjunction with the Senior Medical Director . **Qualifications -...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Evolent (Tallahassee, FL)
- …Participates in on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to ... for utilization management while working in conjunction with the Senior Medical Director . **Qualifications** +...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- AdventHealth (Orlando, FL)
- …and performs other routine duties and special audits and investigations. The Director assists Senior Hospital management by providing independent appraisals, ... by Corporate Responsibility Department staff and/or working with other Hospital Directors, Senior Executives and Medical Staff to obtain their assistance in… more
- CenterWell (Daytona Beach, FL)
- …caring community and help us put health first** Job Description Summary The Associate Medical Director (AMD) is an instrumental clinical leader of our primary ... (clinical, financial, operational) meetings on key topics such as Medical Risk Adjustment (MRA), budgeting, staffing, operational excellence, and clinical… more
- Evolent (Tallahassee, FL)
- …MD provider is recorded in a timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to the Utilization ... the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Evolent (Tallahassee, FL)
- …MD provider is recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization ... the culture. **What You'll Be Doing:** As a Field Medical Director , MSK Surgery you will be...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Humana (Tallahassee, FL)
- …part of our caring community and help us put health first** The Director , Internal Audit develops, plans and evaluates internal audit programs for the organization's ... ensure compliance with the organization's policies, procedures and standards. The Director , Internal Audit requires an in-depth understanding of how organization… more
- CVS Health (FL)
- …resistant illnesses through peer review and educational interventions. * Work with medical director teams focusing on inpatient care management, clinical ... oversight of DSNP/MMP complex populations (Dual-Eligible Special Needs Plan / Medicare -Medicaid Plan) * Develop and lead clinical strategy and objectives for… more
- Danaher Corporation (Orlando, FL)
- …to effectively coordinate and engage targeted customers within the US. Reporting to the Senior Director of Market Access Americas, this highly visible role will ... the Danaher Business System which makes everything possible. The Field Reimbursement Director position is a provider / customer facing role responsible for… more
- Humana (Tallahassee, FL)
- …those customers at the center of everything it does. The MarketPoint Director , Channel Development defines the cross-channel implementation plan to support the sales ... leading national and regional sales growth and retention initiatives. The Director , Channel Development requires a comprehensive understanding of how MarketPoint… more
- Baylor Scott & White Health (Tallahassee, FL)
- … senior leadership, hospital senior leadership, and senior medical staff including denials from all payers, Medicare /Medicaid audit activities and key ... **Job Summary** The Director , Denial Resource Center is responsible for the...improved utilization of appropriate patient care services. Collaborates with medical , clinical, HIM and other BSWH departments to ensure… more
- BD (Becton, Dickinson and Company) (Stuart, FL)
- …**We are** **the makers of possible** BD is one of the largest global medical technology companies in the world. Advancing the world of health (TM) is our ... self. Become a **maker** **of possible** with us. **Position purpose** The National Director of Payor Strategy and Market Access and Payer Strategy, reports to the… more
- CVS Health (FL)
- …And we do it all with heart, each and every day. The Lead Director , National VBC Performance Planning & Insights will act as a strategic leader driving ... guide business decisions for national and local providers. The Director will also play a key role in supporting...efforts and adjusting strategies accordingly + Work closely with Medicare Quality team to ensure that reporting highlights areas… more