- HCA Healthcare (Gainesville, FL)
- …services and administrative activities including fiscal, material and human resource management .? + Maintains and monitors utilization of resources, physical ... HCA Healthcare colleagues invested over 156,000 hours impacting our communities. As a(an) Director Cardiac Cath Lab with HCA Florida North Florida Hospital, you can… more
- Humana (Tallahassee, FL)
- …focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with health insurance ... 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… more
- CVS Health (Jacksonville, FL)
- …and consistent responses to members and providers. Leads all aspects of utilization review /quality assurance, directing case management Provides clinical ... the US.** Aetna, a CVS Health Company, has an exciting opportunity for a Medical Director (Spine) that can be remote based, work from home. The Medical Director … 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
- Molina Healthcare (Orlando, FL)
- …experience as a Molina Medical Director + Demonstrated experience in Utilization /Quality Program management + Previous leadership experience + Peer review ... and expertise in the performance of prior authorization, inpatient concurrent review , discharge planning, case management and interdisciplinary care team… 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
- Highmark Health (Tallahassee, FL)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review , the incumbent participates as the...member of the multidisciplinary team for case and disease management . They will advise the multidisciplinary team on cases,… 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 ... complex actuarial modeling + Collaborates with underwriters, client engagement, and senior management on RFP process and other pricing initiatives related to all… more
- Actalent (Sunrise, FL)
- …activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management + Interqual + Milliman Commercial Guidelines ... utilization . Working under the general supervision of the Director and/or Manager/Supervisor of Medical Management , and...+ Valid Florida Driver's License. + Knowledge of case management and utilization review concepts,… more
- Merck (Tallahassee, FL)
- …headquarters submission (ex-USA). + Manages programs (patient support, educational or risk management ) to support appropriate and safe utilization of Our Company ... **Job Description** **Role Summary:** The Sr. Global Director Medical Affairs (GDMA) is responsible for supporting the execution of scientific & medical affairs… more