- Humana (Tallahassee, FL)
- …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Case managers or Care managers on complex case management , including familiarity with social determinants...size of region or line of business. The Medical Director conducts Utilization Management of… more
- Elevance Health (Tampa, FL)
- …a State agency. **Preferred Qualifications:** + Bilingual- Spanish speaking preferred. + Utilization Management case review experience strongly preferred. + ... **Medical Director - Florida Medicare Plans** Location: This role enables...and Optimum Healthcare Plans and will be responsible for utilization review case management for… more
- CenterWell (Tallahassee, FL)
- …**Additional Information** Will report to the Director of Physician Strategy at Utilization Management . The Medical Director conducts Utilization ... prior experienceparticipatingin teams focusing on transitions of care, quality management ,utilizationmanagement, case management , discharge planning and/or… more
- Evolent (Tallahassee, FL)
- …impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- AdventHealth (Daytona Beach, FL)
- …(manager level or above) in addition to 5 years of direct Care Management / Utilization Management experience and increasing leadership responsibility + RN-BC ... for each position may vary based on geographical location. **Category:** Case Management **Organization:** AdventHealth Daytona Beach **Schedule:** Full-time… more
- J&J Family of Companies (Palm Beach Gardens, FL)
- …processes._ Engineering & Property Services (E&PS) is recruiting for a ** Director Facilities Management ** **(FM) MedTech Make Orthopedics** , located ... employment processes, programs, policies, and benefit plans. In that case , details of any planned changes would be provided...to best serve our important customers and patients. The Director Facilities Management (FM) MedTech Make Orthopedics… more
- Humana (Tallahassee, FL)
- …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , or similar activities **Preferred ... community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare...Integrated Delivery Systems, health insurance, or clinical group practice management + Utilization management experience… more
- Molina Healthcare (Jacksonville, FL)
- …**Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs ... management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization management and case ...EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in… more
- Highmark Health (Tallahassee, FL)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member...need. **Preferred** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral… more
- Molina Healthcare (Jacksonville, FL)
- …of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies ... the most appropriate care at the most effective setting. *Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and… more