- CVS Health (Tallahassee, FL)
- …treatment protocols for DSNP/MMP and other complex health populations to optimize risk adjustment, clinical quality, and care management. * Actively participate in ... programs to ensure providers deliver appropriate, high-quality, cost-effective Health Risk Assessments and other clinical services that are evidence-based. *… more
- AdventHealth (Altamonte Springs, FL)
- …into IT performance trends and improvement opportunities; - Manage audit processes and risk controls to ensure regulatory and compliance alignment; - Execute ... Full Time **Shift** : Monday Friday **The role you'll contribute:** Director Service Management Governance is responsible for IT Performance, Audit, Change… more
- Bausch + Lomb (Clearwater, FL)
- …and risk management to ensure robust product performance and compliance throughout the product lifecycle. Engage with key opinion leaders (KOLs), surgeons, ... the advancement of eye health in the future. **POSITION OVERVIEW** The Senior Director , Intraocular Lens & Inserter Development will lead the strategic and technical… more
- Evolent (Tallahassee, FL)
- …the culture. **What You'll Be Doing:** Evolent is seeking an **Associate Medical Director - Cardiovascular Medicine** to play a critical role in **Performance Suite ... risk arrangements with payers and strategic utilization management initiatives.**...Offer **clinical rationale for standard and expedited appeals,** ensuring compliance with UM policies and regulatory requirements. + Collaborate… more
- Molina Healthcare (Tampa, FL)
- **Job** ** ** **Summary** Safeguard member trust and plan compliance by owning Molina's entire CMS Complaints Tracking Module (CTM) life cycle. As Director of ... the correct business owner on first touch. 2. Resolution Quality & Compliance Mastery * Track record coordinating cross-functional action plans with Enrollment,… more
- MUFG (Tampa, FL)
- …provide more details. **Job Summary:** This position will report to the FLoD Director Third-Party Management and will be principally engaged in execution of the ... Third-Party Risk (TPRM) Management oversight of the highest risk...of the program throughout the full TPRM Lifecycle. + Compliance with applicable rules and guidance impacting the TPRM… more
- Cengage Group (Jacksonville, FL)
- …. We are seeking an experienced and visionary **Sr. Director of DevOps & Automation** to lead our enterprise-wide strategy ... and engineering teams. You'll also collaborate with Product, Security, Compliance , and Infrastructure to ensure high-performance, resilient, and secure delivery… more
- AssistRx (Orlando, FL)
- …standards (eg, HIPAA, 21 CFR Part 11, OIG guidance). + Collaborate with legal, compliance , and quality teams to manage risk and maintain audit readiness. + ... As Senior Director of Product Management, you will lead a...to validate product direction and improve user experience. + Compliance & Quality + Ensure all offerings meet applicable… more
- Humana (Tallahassee, FL)
- …CarePlus is seeking a talented healthcare/health insurance leader for the role of Director , Provider Contracting. The Director will be responsible for all ... Degree + Experience with Specialty/Ancillary contracting + Experience with ACO/ Risk Contracting + Value based contracting experience **Additional Information** This… more
- Growth Ortho (Tampa, FL)
- Job Title: Director of Payer Strategy & Contracting Location: Remote (with limited travel, approx. 2 4 days/month) Reports To: SVP, Revenue Cycle Organization: ... Position Summary: Growth Orthopedics (GO) is seeking a strategic and experienced Director of Payer Strategy & Contracting to lead enterprise-wide initiatives that… more