- Humana (Tallahassee, FL)
- …a part of our caring community and help us put health first** The Director , Financial Planning & Analysis analyzes and forecasts financial, economic, and other data ... accurate and timely information for strategic and operational decisions. The Director , Financial Planning & Analysis requires an in-depth understanding of how… more
- Humana (Tallahassee, FL)
- …support across a broad range of actuarial, managerial, and business needs for Medicaid -specific product lines. The Lead Actuary will serve as a project manager in ... and documentation. The Lead Actuary will be responsible for Medicaid -specific functions such as capitation rate review, drafting rate...on the business. They will work closely with the Director to ensure key workstreams are meeting timelines and… more
- Evolent (Tallahassee, FL)
- …setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional cardiology to ... innovation, continuous improvement, and clinical excellence. + **This position is 100% Remote and can be completed from any state. Multiple opportunities for a… more
- Molina Healthcare (Miami, FL)
- …surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Program Director is a key Quality Improvement (QI) leader within the ... needs. + Manages QI programs with oversight from the Director , AVP and VP as needed. + Collaborates and...of and experience with HEDIS programs. + 2 years Medicaid experience + 2 years Medicare experience + 3… more
- Molina Healthcare (Jacksonville, FL)
- …standards and requirements established by the Centers for Medicare and Medicaid . **Knowledge/Skills/Abilities** * Leads, organizes, and directs the activities of the ... within a managed care setting. **Preferred Education** Bachelor's degree Previous Director experience. To all current Molina employees: If you are interested… more
- IQVIA (Orlando, FL)
- …Execute the effective launch of new drugs in Managed Care accounts, PBMs, Medicaid PBMs, and State Government Accounts by introducing product lines to accounts with ... the goal to gain formulary inclusion and pull-through for the best interest of the client + Develop and build strong relationships with all key Accounts. + Collect competitor information, marketplace trends, and relevant client information to report to… more
- Molina Healthcare (Tampa, FL)
- …with business and other IT teams to deliver successful and certifiable Medicaid Management Information Systems solutions. * Works closely with EPMO, business ... stakeholders to manage priorities deliveries and expectations. **Job Qualifications** **Required Education** Graduate Degree or equivalent combination of education and experience **Required Experience** 7-9 years Application Design, Development Experience and,… more
- Humana (Tallahassee, FL)
- …community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. The Behavioral ... Health Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of… more
- Humana (Tallahassee, FL)
- …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director ... must be able to start with 30-60 days of hire. The Medical Director actively uses their medical background, experience, and judgement to make determinations whether… more
- Humana (Tallahassee, FL)
- …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director ... or data requires an in-depth evaluation of variable factors. The Medical Director provides medical interpretation and decisions about the appropriateness of services… more