- CVS Health (Jacksonville, FL)
- …consistent responses to members and providers. Leads all aspects of utilization review /quality assurance, directing case management Provides clinical expertise ... Health Company, has an exciting opportunity for a Medical Director (Spine) that can be remote based, work from...can be remote based, work from home. The Medical Director (Spine) will be a Subject Matter Expert (SME)… more
- Prime Therapeutics (Tallahassee, FL)
- …every decision we make. **Job Posting Title** Clinical Solutions Strategy Senior Director - Remote **Job Description** The Clinical Solutions Strategy Senior ... Director is responsible for developing new, bold clinical solutions...and implementation of innovative drug solutions, including optimizing drug utilization , patient outcomes, and cost-effectiveness through value-based care models,… more
- CBRE (Tallahassee, FL)
- Business Intelligence Director Job ID 229566 Posted 29-Jul-2025 Service line GWS Segment Role type Full-time Areas of Interest Data & Analytics, Facilities ... Effectively recommends same for direct reports to next level management for review and approval. Plans and monitors appropriate staffing levels and utilization… more
- Prime Therapeutics (Tallahassee, FL)
- …fuels our passion and drives every decision we make. **Job Posting Title** Sr. Director Actuarial Forecasting - REMOTE **Job Description** The Senior Director of ... functional leadership to develop and maintain projected trend assumptions related to utilization , unit cost, and gross/net rebate assumptions + Owns the annual… more
- Prime Therapeutics (Tallahassee, FL)
- …and drives every decision we make. **Job Posting Title** Sr Director Clinical Strategy and Oncology Specialty Solutions/PharmD required- REMOTE **Job Description** ... The Senior Director Clinical Strategy and Oncology Specialty Solutions is responsible for owning the execution of Prime's oncology specialty products and programs,… more
- Select Medical (Miami, FL)
- …documentation related to the hospital's CQI program. + Performs basic chart review activities with appropriate staff for outcome utilization , infection control ... with Select Medical* **Location: Miami, FL** **$10,000 Sign-on Bonus** ** Director of Quality Management** **(DQM)** **Responsibilities** **Position Summary** Coordinates… more
- Highmark Health (Tallahassee, FL)
- …NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review , the incumbent participates as the physician member of the ... **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most… more
- University of Miami (Coral Gables, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Unanue ... Herbert Business School is actively searching for an experienced Executive Director . This leader will spearhead the Unanue Graduate Career Advancement department,… more
- University of Miami (Miami, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The ... Department of Surgery has an exciting opportunity for a full time Director , Laboratory Services position. The incumbent directs and manages the overall operation,… more
- MTC (Graceville, FL)
- …improvement committee. 7. Closely monitor all potential catastrophic events and perform utilization review and tracking. 8. Submit and implement recommendations ... Monitor delivery of mental health care, audit patient records, review and complete monthly statistical reports, analyze, distribute, and...for improvements in services and optimal utilization of staff. 9. Develop and monitor effectiveness of… more