- CVS Health (FL)
- …illnesses through peer review and educational interventions. * Work with medical director teams focusing on inpatient care management, clinical coverage ... review , member appeals clinical review , medical claim review , and provider appeals clinical review . * Actively participate in scheduled team meetings… more
- Humana (Tallahassee, FL)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and ... preservice appeals. The Corporate Medical Director works on problems of diverse...services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Represents Humana at… more
- Evolent (Tallahassee, FL)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , Physical Medicine and Rehab you will be a key member of the ... recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management… more
- Molina Healthcare (Orlando, FL)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... + 3+ years relevant experience, including: + 2 years previous experience as a Medical Director in a clinical practice. + Current clinical knowledge. + Experience… more
- CDR Maguire (Tallahassee, FL)
- Evita Med Spa is seeking a board-certified Dermatologist to join our team as Medical Director at our Tallahassee location. This role serves as the clinical ... to ensure safe, effective, and ethical care. In this leadership role, the Medical Director , a board-certified dermatologist, is responsible for maintaining full… more
- Sedgwick (Tallahassee, FL)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr. VP Medical Director **PRIMARY PURPOSE** **:** To evaluate medical reports ... review process including making a recommendation of specialty for the Independent Medical Review process. + Developing and delivering training materials and… more
- Select Medical (Oxford, FL)
- **Overview** **Critical Illness Recovery Hospital** ** Director of Case Management** **_Clinical license as a registered nurse or respiratory therapist or master's in ... social work and minimum three (3) years of medical case management or similar experience._** **Previous case mangement...doing well by doing what is right. As the Director of Case Management **,** you will use your… more
- Molina Healthcare (St. Petersburg, FL)
- …3+ years HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization/Quality Program management + ... Supervises and manages Medical Directors + Develops medical policies and procedures + Conducts peer review... medical policies and procedures + Conducts peer review **JOB QUALIFICATIONS** **REQUIRED EDUCATION:** * Doctorate Degree in… more
- CenterWell (Daytona Beach, FL)
- …caring community and help us put health first** Job Description Summary The Associate Medical Director (AMD) is an instrumental clinical leader of our primary ... (clinical, financial, operational) meetings on key topics such as Medical Risk Adjustment (MRA), budgeting, staffing, operational excellence, and clinical… more
- CenterWell (Jacksonville, FL)
- …a part of our caring community and help us put health first** The Associate Medical Director (AMD) is an instrumental clinical leader of our primary care team, ... (clinical, financial, operational) meetings on key topics such as Medical Risk Adjustment (MRA), budgeting, staffing, operational excellence, and clinical… more