• Medical Director , Clinical Services

    Highmark Health (Tallahassee, FL)
    …year in Medical Management in a Health Insurance Plan; strong knowledge of managed care industry **LICENSES AND CERTIFICATION** **Required** + Medical Doctor or ... + Telephone Skills + General Computer Skills + Clinical Software + Managed Care **Language (Other than English)** None **Travel Required** 0% - 25% **PHYSICAL,… more
    Highmark Health (07/29/25)
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  • Lead Director , Project Program Management…

    CVS Health (Tallahassee, FL)
    …significance or those yielding cost savings. + 10+ years of experience in managed care , health insurance, marketing, or related industries. + Competency in ... organizational levels, including executive leadership. **Preferred Qualifications** + Experience within managed care or the health insurance industry. +… more
    CVS Health (08/28/25)
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  • Medical Director Physician Advisor UM…

    AdventHealth (Tampa, FL)
    …is responsible for educating, informing and advising members of the Utilization Management, Care Management, Managed Care and Revenue Cycle departments and ... AdventHealth Division AdventHealth Tampa, a faith-based not-for-profit 626-bed tertiary-level acute care hospital located in the uptown district of Tampa, Florida,… more
    AdventHealth (08/27/25)
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  • Director Reimbursement Design & Market…

    Highmark Health (Tallahassee, FL)
    …Consulting or related area + 3 years Value-based reimbursement, through managed care contracting, provider reimbursement, consulting, population health delivery ... and maintains strategic provider relationships to understand the current health care delivery state, readiness for change, test value based programming concepts… more
    Highmark Health (07/30/25)
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  • Director Credentialing Operation

    AdventHealth (Tampa, FL)
    …standards and CMS. Works with AdventHealth Medical Group (AHMG), AdventHealth leadership, Managed Care Organizations and other departments within AdventHealth to ... Division . AdventHealth Tampa, a faith-based not-for-profit 626-bed tertiary-level acute care hospital located in the uptown district of Tampa, Florida, specializes… more
    AdventHealth (08/07/25)
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  • Director , Medicare Duals Optimization…

    Molina Healthcare (FL)
    …Qualifications** **REQUIRED QUALIFICATIONS:** + At least 10 years' experience in Managed Care , specifically government programs and/or Medicare/Duals Health Plan ... Operations or equivalent combination of education and experience. + Strong leadership in a matrixed environment + Demonstrated adaptability and flexibility to a rapidly moving business environment. + Background analyzing technical performance and driving teams… more
    Molina Healthcare (08/22/25)
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  • Director of Operations

    Mass Markets (FL)
    …applicant on the basis of age, ancestry, color, family or medical care leave, gender identity or expression, genetic information, marital status, medical condition, ... Provider (DXP), Account Receivables Management (ARM), Application Software Development, Managed Services, and Technology Services, to mid-market, Federal &… more
    Mass Markets (08/01/25)
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  • Medical Economics Manager

    AdventHealth (Maitland, FL)
    …analysis and evaluation of financial and economic data related to healthcare costs and managed care payer rates and reimbursement. The role focuses on financial ... able to complete extensive and complex financial, operational, and analysis of managed care contracts, proposals, analyze fee schedules, and determine contract… more
    AdventHealth (08/19/25)
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  • Remote LPN Care Manager

    Actalent (Maitland, FL)
    …management expertise + Pediatrics experience + Knowledge of Microsoft Suite + Experience in managed care + Acute care experience Additional Skills & ... on internal protocols under the supervision and direction of a medical director . Responsibilities + Conduct day-to-day care management activities including… more
    Actalent (08/22/25)
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  • Emergency Medicine/Critical Care Physician…

    University of Florida (Jacksonville, FL)
    …and Critical Care Medicine Programs to community physicians and managed care organizations. + Participate in monthly division meetings, administrative ... Emergency Medicine/Critical Care Physician & Clinical Assistant/Associate Professor Apply now...Emergency Medicine. This position will report to the Medical Director at the assigned site and Chairman of the… more
    University of Florida (08/27/25)
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