- Elevance Health (Tampa, FL)
- **Appeals Medical Director - Medicare ** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person ... as required by law. Alternate locations may be considered. The **Appeals Medical Director ** is responsible for the appeal reviews for physical health medical… more
- Elevance Health (Tampa, FL)
- ** Medical Director - Florida Medicare Plans** Location: This role enables associates to work virtually full-time, with the exception of required in-person ... must reside in Florida near our Miami or Tampa locations.** The ** Medical Director ** will support the following Florida Medicare plans: Simply Healthcare… more
- Molina Healthcare (St. Petersburg, FL)
- JOB DESCRIPTION Job Summary Provides medical oversight and expertise in appropriateness and medical necessity of services provided to members, targeting ... and cost-effective member care. Essential Job Duties * Determines appropriateness and medical necessity of health care services provided to plan members. * Supports… more
- 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
- Humana (St. Petersburg, FL)
- …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 ... community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work under the guidance of...under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you'll… more
- Help at Home (Tampa, FL)
- …of health, care coordination, and Meaningful Moments that transform lives_ . The Director of Nursing (DON) is responsible for all nursing services, supervision of ... scalable nursing oversight and overall operational performance Our Benefits: + Comprehensive medical , dental, and vision coverage + 401(k) retirement plan + Paid… more
- Molina Healthcare (St. Petersburg, FL)
- …to standardize policies and procedures. + Recruits, hires, trains, mentors, and develops medical director staff and team members as needed. + Ensures ... behavioral health and at least 3 years as a medical director in a managed care setting...management policies across health plans or navigating varied state Medicaid/ Medicare regulations. + Working knowledge of national, state, and… more
- Molina Healthcare (St. Petersburg, FL)
- …reviews behavioral health portions of state contracts. * Assists behavioral health medical director lead trainers in the development of enterprise-wide education ... JOB DESCRIPTION Job SummaryProvides medical oversight and expertise related to behavioral health...National Committee for Quality Assurance (NCQA) and Centers for Medicare and Medicaid Services (CMS). * Assists with the… more
- Bausch + Lomb (Tampa, FL)
- …**Overview** Through depth and breadth of customer and industry knowledge, the ** Director , National Accounts** will be responsible for aiding in the development of ... these programs it is also the expectation that the National Account Director will take responsibility for communication, facilitation and implementation with these… more
- Bluestone Physician Services (Tampa, FL)
- Student Onboarding POSITION SUMMARY The Clinical Practice Director is a nurse practitioner or physician assistant who is responsible for Market level oversight of ... Florida. Reporting to the SVP of Clinical Practice, the Clinical Practice Director functions independently using effective leadership skills. The Clinical Practice … more
- HCA Healthcare (Tampa, FL)
- …colleagues invested over 156,000 hours impacting our communities. As a(an) Home Health Director with TriStar Healthcare at Home, you can be a manager in an ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...location._** Come join our team as a(an) Home Health Director . We care for our communities and employees! HCA… more
- BrightSpring Health Services (Clearwater, FL)
- …with Company policies and procedures, state licensure and regulations, Medicaid and Medicare standards, as well as state reimbursement regulations + Leading case ... nursing and direct care staff, family and/or guardians, and community medical providers and professional consultants in cooperation with operations management +… more
- Guidehouse (Tampa, FL)
- …None **What You Will Do** **:** + Under the direction of the Director of Revenue Integrity, the Revenue Integrity Coding Billing Specialistprovides revenue cycle ... services through efficient review and timely resolution of assigned Medicare and third-party payer accounts that are subject to...Coding Initiatives (CCI) + Medically Unlikely Edits (MUE) + Medical Necessity edits + Other claim level edits as… more
- CenterWell (Pinellas Park, FL)
- …participant and lead with the care team through daily huddles. + Helps Regional Medical Director (RMD), Physician and Center Administrator in setting a tone of ... Appropriate certification to write prescriptions under the authority of a collaborating physician/ medical director . + This role is considered patient facing and… more
- 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
- CenterWell (Clearwater, FL)
- … medical expertise with the care team through daily huddles. . Helps regional medical director and center administrator in setting a tone of cooperation in ... doctors, advanced practice professionals, pharm D, care coach nurses, medical assistants, behavioral health, specialists, quality-based coders, referral coordinators… more
- CenterWell (Tampa, 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
- 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 (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 (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