- Humana (Tallahassee, FL)
- … relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex issues where ... understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to … more
- Humana (Tallahassee, FL)
- … relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex issues where ... The Medical Director 's work includes computer based review of moderately complex to complex clinical scenarios, review of all submitted clinical records,… more
- Community Health Systems (Naples, FL)
- The **System Director of Risk Management** is a key leader responsible for overseeing risk management, patient safety, and regulatory compliance across Physicians ... Regional Healthcare System. This role ensures compliance with federal, state,...collaborate with one to support quality and safety initiatives. ** Claims & Litigation Management** + Oversee legal claims… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- …our focus to ultra-rare neurological conditions. **Job Summary** The Executive Director , Sales and Marketing, Neurology Rare Disease will be responsible for ... This role involves leading HCP and patient engagement, understanding the evolving complex journey to diagnosis, leading account teams, and aligning with the broader… more
- Evolent (Tallahassee, FL)
- …Management** and **Product Management** , leveraging advanced analytics to solve complex healthcare challenges and support impactful decision-making that ... Codes, CPT Codes, RVUs, bundled payments, etc. + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing… more
- Pfizer (Tampa, FL)
- The ** Director , Patient Affordability Analytics** is responsible for leading and innovating data assets and strategies for the creation and measurement of Pfizer's ... patient affordability and copay programs. The Director will be integral in helping develop data and...affordability data/analytics platforms. + Display and implement knowledge of healthcare industry and trends that could affect Pfizer's patient… more
- Evolent (Tallahassee, FL)
- …or related healthcare consulting entity + Extensive knowledge of healthcare claims ; specifically, differences between institutional vs professional billing ... providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and...+ At least 5 years of professional experience in claims -based healthcare analytics with a payer, provider,… more
- Elevance Health (FL)
- …payment integrity, or provider performance programs preferred. + Strong understanding of healthcare data systems ( claims , EHR, analytics platforms) and payer ... **Manager, Medical Director - Transformation Initiatives** Location: This role requires...initiatives that impact providers, members, and clients across the healthcare ecosystem. **How you will make an impact:** **Strategic… more
- Evolent (Tallahassee, FL)
- …rates, turnaround times, PMPM, trend drivers), with a working knowledge of healthcare claims and reimbursement methodologies. + Experience presenting actionable ... Be Doing: + Strategic Data Analytics & Insights: Lead advanced analyses of healthcare authorization, claims , membership data, and clinical outcomes to uncover… more
- Akumin (Port St. Lucie, FL)
- We are seeking an experienced, strategic, and results-driven Senior Director of Billing and Collections to lead our end-to-end billing operations. This senior ... oversee all facets of the billing lifecycle, including charge capture, claims management, collections, cash application, denial resolution, and system optimization.… more