- NASCO (Tallahassee, FL)
- **Overview** The Senior Corporate Counsel, Compliance & Commercial operates under general direction and is responsible for providing legal and regulatory guidance to ... and drafts complex commercial transactions, including technology agreements, and provides compliance guidance and support throughout the organization to ensure our… more
- Humana (Tallahassee, FL)
- …determinations, clinical reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare ... clinical group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed… more
- Humana (Tallahassee, FL)
- …clinical group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed ... **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The … more
- Humana (Ocala, FL)
- …and contracting teams to promote provider engagement with Humana and ensuring compliance and marketing guidelines associated with Medicare regulations are ... first** Our Senior Manager, MarketPoint Sales motivates and drives a team of Medicare Sales Field Agents who sell individual health plan products and educate… more
- BAYADA Home Health Care (Jacksonville, FL)
- …You'll Do as Director:** + Provide leadership and strategic direction to ensure compliance with Medicare regulations and state/ federal laws governing home ... candidate will have a strong background in healthcare administration, regulatory compliance ( Medicare Conditions of Participation), clinical coordination, and… more
- Humana (Miami, FL)
- …Identifies through a screening process for potential eligibility for state and federal benefits. + Ensures member is progressing towards desired outcomes by ... based on business needs and hours could include weekends/holidays. + During the Medicare Annual Election Period, September to December, must be able to work Monday… more
- Humana (Tallahassee, FL)
- …(DVACO) is an accountable care organization that participates in the Centers for Medicare and Medicaid Services' Medicare Shared Savings Program (MSSP), plus ... other commercial and Medicare Advantage value based programs. DVACO is a joint...starting your FIRST day of employment. Benefits include: + Medical Benefits + Dental Benefits + Vision Benefits +… more
- Evolent (Tallahassee, FL)
- …is preferred + Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified ... non-clinical setting? Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology… more
- Evolent (Tallahassee, FL)
- …is preferred + Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified ... culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of...the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review… more
- Evolent (Tallahassee, FL)
- …Computer Proficiency + Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified ... Doing: + Serve as the Physician match reviewer in Medical Oncology and imaging cases, that do not initially...the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review… more