- Evolent (Tallahassee, FL)
- …mission with a company behind it. **What You'll Be Doing:** **Associate Director , Performance Analytics - Oncology & Member Product Focus** **Overview:** Evolent is ... seeking an experienced and strategic **Associate Director of Performance Analytics** to lead data-driven initiatives focused on oncology and member-centric products.… more
- Sedgwick (Tampa, FL)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Director Data Tools, Governance and Architecture **PRIMARY PURPOSE OF THE ROLE:** This ... the overall enterprise architecture and minimize costs. The Tech Director will collaborate closely with the Enterprise Architecture ,...(eg, Master's or Ph.D.) in a relevant field is preferred + 10+ years of experience in a leadership… more
- Humana (Tallahassee, FL)
- …Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate Medical Director works on problems ... and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions regarding the appropriateness and… more
- Cordis (Miami Lakes, FL)
- …us as we transform cardiovascular care. **Responsibilities** **Job Summary:** The Director of Market Access is responsible for developing and executing strategies ... with autonomy. Provide on-site and virtual expert guidance to resolve claim denials, appeal challenges, and billing disputes-ensuring institutions are equipped to… more
- Centene Corporation (Tallahassee, FL)
- …perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement ... of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies to improve quality… more
- Humana (Tallahassee, FL)
- …Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on problems ... and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the appropriateness of… more
- The Cigna Group (Tallahassee, FL)
- **Position Summary** The Supplemental Health National Sales Director (NSD) will be responsible for driving new business sales for Supplemental Health products in ... Internal capabilities and external options + Administrative solutions: Billing and claim processes The NSD role is responsible for proactive and consultative… more
- Molina Healthcare (St. Petersburg, FL)
- …activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare, Medicaid, ... focused reviews and recommends corrective actions. + Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care.… more
- Evolent (Tallahassee, FL)
- …the mission. Stay for the culture. **Who You'll Be Working With:** The Director , Performance Suite Analytics, utilizes and develops analytic tools to solve complex ... public health, biology) + At least 5 years of professional experience in claims -based healthcare analytics with a payer, provider, vendor, managed care, or related… more
- DOCTORS HEALTHCARE PLANS, INC. (Miami, FL)
- Position Summary: The Director of Medical Management is responsible for the strategic direction, leadership, and oversight of all medical management functions, ... with internal stakeholders including the Chief Medical Officer, Provider Relations, Claims , and IT to ensure seamless integration of medical management processes.… more