- Humana (Tallahassee, FL)
- …. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial ... operationalize this knowledge in their daily work. The Medical Director 's work includes computer based review of...size of region or line of business. The Medical Director conducts Utilization Management of… more
- Molina Healthcare (FL)
- … and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure ... IT and data analysts to produce tools to report, monitor and improve Utilization Management . + Actively participates in regulatory, professional and community… more
- Humana (Tallahassee, FL)
- …. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial ... operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately...size of region or line of business. The Medical Director conducts Utilization Management of… more
- Humana (Tallahassee, FL)
- …management + Utilization management experience in a medical management review organization, such as Medicare Advantage and managed Medicaid + ... quality of care, audit, grievance and appeal and policy review . The Behavioral Health Medical Director will...with prior experience participating in teams focusing on quality management , utilization management , case … more
- Evolent (Tallahassee, FL)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Evolent (Tallahassee, FL)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Evolent (Tallahassee, FL)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... cases. you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Humana (Tallahassee, FL)
- …. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in… more
- University of Miami (Miami, FL)
- …energy operations, and environmental services operations of assigned facilities. The Director will provide leadership to management staff and oversees ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The University of… more
- HCA Healthcare (Brooksville, FL)
- …Healthcare Quality) OR CHCQM (Diploma in American Board of Quality Assurance and Utilization Review Physicians). _Individuals without CPHQ or_ CHCQM _will be ... today!** **Job Summary and Qualifications** We are seeking a Director of Quality Management . As our ...a healthcare environment + Previous experience in accreditation, quality, utilization management , or risk management … more