- Highmark Health (Tallahassee, FL)
- …to evaluate the medical necessity and appropriateness of the requested treatment of service . Depending on the nature of the case, telephonic peer to peer discussions ... in Medical Management in a Health Insurance Plan; strong knowledge of managed care industry **LICENSES AND CERTIFICATION** **Required** + Medical Doctor or Doctor… more
- HCA Healthcare (Sunrise, FL)
- …a preferred partner to thousands of top-performing hospitals, we are the largest managed services provider in the healthcare industry. With over 28,000 ... individual is recognized. Submit your application for the opportunity below: Director of Marketing with HealthTrust Workforce Solutions! **Benefits** HealthTrust… more
- AdventHealth (Maitland, FL)
- **Executive Director Network & Payor Development AdventHealth PHSO Resources** **All the benefits and perks you need for you and your family:** + Benefits from Day ... WAY, Maitland, 32751 **The role you'll contribute:** The Executive Director works with executive and senior leadership teams to...must have a passion for delivering high-quality and high-touch service to our community and have a genuine commitment… more
- AdventHealth (Altamonte Springs, FL)
- …improvement and reporting + Reviews denials data and trends and works with Managed Care contracting team and patient financial services to identify opportunities ... educating, informing and advising members of the Utilization Management, Care Management, Managed Care and Revenue Cycle departments and applicable medical staff, as… more
- Prime Therapeutics (Tallahassee, FL)
- …and drives every decision we make. **Job Posting Title** Clinical Program Management Director - Remote **Job Description** **Are you looking for a client facing ... clinical products, formulary, and UM strategies.** The Clinical Account Director is responsible for the management of all client...Management programs, and other drug therapy related products and services offered by Prime. As the primary point of… more
- Insight Global (Maitland, FL)
- …5 years of CDI director or manager in large hospital (must have managed large teams in multiple locations) Active RN license (must have active by the time ... changes related to ICD-10. A commitment to excellent customer service and respectful relationships is essential. Leading a team...director or manager in large hospital (must have managed large teams in multiple locations) Active RN license… more
- CenterWell (Tallahassee, FL)
- …Primary Care's) highest need and complexity patients with care and case management services . The Director is response for the strategic direction, execution and ... part of our caring community and help us put health first** The National Director , Care Integration Strategy & Program will be responsible for the end-to-end program… more
- Humana (Tallahassee, FL)
- …our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. ... The Corporate Medical Director works on problems of diverse scope and complexity...and decisions regarding the appropriateness and medical necessity of services provided by other healthcare professionals in compliance with… more
- Ensono (Miami, FL)
- …that reshape how our world runs. As an expert technology adviser and managed service provider with cross-platform certifications, Ensono empowers our clients to ... Director Solution Delivery Architecture - MainframeRemote - United...of mainframe solutions with a focus on software and service transition. Will be responsible for multiple mainframe technical… more
- YesCare Corp (Tallahassee, FL)
- …physician assistants or nurse practitioners as required. + Notifies Regional Medical Director and Site Health Services Administrator of schedule changes. Assists ... or Occupational Medicine) with administrative experience in corrections and/or managed healthcare delivery. + Current DEA registration. Board certified, eligible,… more