- 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 (Tampa, FL)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Molina Healthcare (Tampa, 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
- Molina Healthcare (Tampa, 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 (Lakeland, 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
- Molina Healthcare (Tampa, FL)
- …Certification in Psychiatry **REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in ... (TX) Medical License, free of sanctions from Medicaid or Medicare . **Preferred Experience** * Peer Review, medical policy/procedure development, provider… more
- Molina Healthcare (Tampa, 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
- AdventHealth (Tampa, FL)
- **Basic Function** The Fellowship Program Director , in accordance with the specific accreditation body, has responsibility and accountability for the operation of ... well-being. + Oversight of scholarly activities The Fellowship Program Director reports to the Sponsoring Institution's Chief Academic Officer/Designated… more
- Molina Healthcare (Tampa, FL)
- …with the standards and requirements established by the Centers for Medicare and Medicaid **Knowledge/Skills/Abilities** * Leads, organizes, and directs the ... to members or authorized representatives in accordance with Centers for Medicare and Medicaid standards/requirements. * Provides direct oversight, monitoring and… more
- Grifols Shared Services North America, Inc (Clearwater, FL)
- …and services in more than 110 countries and regions. The Associate Director , Value Access Marketing & Reimbursement is responsible for developing and executing ... access customer segment . Support reimbursement, coding, and coverage-related responsibilities for Medicare Part B, Centers for Medicare and Medicaid (CMS)… more
- HCA Healthcare (Tampa, FL)
- …in 21 states and the United Kingdom. We are looking for a Division Director of Regulatory and Accreditation for our HCA Healthcare team where excellence creates ... 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… more
- Danaher Corporation (Tampa, FL)
- …the Danaher Business System which makes everything possible. The Field Reimbursement Director position is a provider / customer facing role responsible for ... coordinate and engage targeted customers within the US. Reporting to the Senior Director of Market Access Americas, this highly visible role will play a pivotal… more
- Aveanna Healthcare (Lakeland, FL)
- Home Health Area Director of Sales ApplyRefer a FriendBack Job Details Requisition #: 208451 Location: Lakeland, FL 33804 Category: Clinical Care and Support Salary: ... - $125,000.00 per year Position Details Position Overview: TheArea Director of Sales, Home Health, will direct and Manage...of a team of sales professionals selling Skilled Intermittent Medicare Certified Home Health services to members of the… more
- Molina Healthcare (Tampa, FL)
- …and Joint Operating Committees. * Manages and reports network adequacy for Medicare , Marketplace, and Medicaid services. * In conjunction with direct management and ... recontracting initiatives. Implements cost control initiatives to positively influence the Medical Care Ratio (MCR) in each contracted region. * Leads preparation… more
- Bristol Myers Squibb (Tampa, FL)
- …of a team responsible for accurate and timely Managed Care Commercial and Medicare Part D rebate processing and payments, data stewardship and compliance in ... conditions of the applicable plans then in effect and may include the following: Medical , pharmacy, dental and vision care. Wellbeing support such as the BMS Living… more
- ChenMed (Lakeland, FL)
- …and runs referral team meeting- Create agenda for meeting. Gather info from Medical Director /Network Director /Referral Manager. + Prepares Referral ... Team Meeting Minutes and send minutes to Operation Director , Market Medical Director , Market...experience/understanding + Understanding of cost as it relates to Medicare parts A, B and D + Proficient in… more
- Option Care Health (Tampa, FL)
- …of patient care is maintained. The Nurse Manager is responsible for assisting the Director of Operations and/or Area Director of Nursing in meeting operational ... spent providing clinical patient care activities. Per state regulation requirements, the Director of Nursing title will be used. **Job Description:** **Job… more
- ChenMed (Lakeland, FL)
- …is a transitional position towards becoming a center clinical P&L leader (ie, Senior Medical Director [SMD]) in the organization. The incumbent Center Medical ... organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a...simultaneously completing PCP Black Belt Training and Mastering the Medical Director Essentials within a combined and… more
- CenterWell (Lutz, 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 ... to write prescriptions under the authority of a collaborating physician/ medical director . + This role is considered...and English + Active and unrestricted DEA license + Medicare Provider Number/ Medicaid Provider Number + Experience managing… more
- ChenMed (Clearwater, FL)
- …specific geographic regions. This individual will report to and work with the Network Director to develop the CPL and serve as the local relationship builder with ... Specialty, MED COE and HCT leaders to support improved medical costs and specialty care utilization. This individual will...individual will report to and work with the Network Director to develop the CPL and serve as the… more