• Behavioral Health Nurse - Managed Care

    DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
    …in utilization of resources, avoidable days/denials. Works in collaboration with Appeals Management /Medical Director in the appeals process. + Responsible for ... health needs, develop individualized care plans, and ensure cost-effective, quality care in accordance with regulatory guidelines and organizational policies.… more
    DOCTORS HEALTHCARE PLANS, INC. (08/24/25)
    - Related Jobs
  • Provider Contracts Manager

    Molina Healthcare (St. Petersburg, FL)
    …systems, hospitals and physician groups that result in high quality , cost effective and marketable providers. **KNOWLEDGE/SKILLS/ABILITIES** + In conjunction ... with Director /Manager Provider Contracts, negotiates high priority physician group and...+ Develops and maintains provider contracts in APTTUS contract management software. + Targets and recruits additional providers to… more
    Molina Healthcare (08/28/25)
    - Related Jobs
  • Supervisor, Medicare Pharmacy Operations/Call…

    Molina Healthcare (St. Petersburg, FL)
    …pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. **Job Duties** + Hires, trains and manages a ... activities and processes are compliant with CMS and National Committee of Quality Assurance (NCQA) guidelines and Molina policies and procedures. + Participates in… more
    Molina Healthcare (08/13/25)
    - Related Jobs
  • Project Manager - Healthcare - Remote

    AssistRx (Orlando, FL)
    The Project Manager will be a member of the PMO Team, reporting to the Director of Program Management . The PMO Team leads client software implementation projects ... and works closely with the Product Management team to identify opportunities and develop solutions. The...is a highly technical position with accountability for product quality that requires the ability to motivate and mentor… more
    AssistRx (07/29/25)
    - Related Jobs
  • Interim VP of Quality

    HealthTrust Workforce Solutions (Trinity, FL)
    …access to more than 200,000 jobs nationwide. **_JOB SUMMARY_** The Interim Manager/ Director of Quality Management and Infection Prevention manages ... **_EDUCATION & EXPERIENCE_** + Bachelor's Degree with preference given to Nursing, Quality Management or Healthcare Administration, or ten years + experience… more
    HealthTrust Workforce Solutions (08/18/25)
    - Related Jobs
  • Manager, Strategic Account Manager - Remote…

    AssistRx (Orlando, FL)
    …manufacturing partners. In this role, you'll be working with pharmaceutical executives (Associate Director and above) on a daily basis to ensure they are receiving ... with the client through regular meetings/conference calls to review service quality and ensure they are receiving maximum benefit from iAssist's features… more
    AssistRx (08/03/25)
    - Related Jobs
  • Program Manager, Clinical Operations…

    ChenMed (Miami, FL)
    …collaborating with various departments and colleagues, including Safety Officer, Human Resource, Quality Officer, National Director Quality & Patient ... great people to join our team. The Program Manager, Clinical Operations & Quality oversees all occupational safety & health and infection prevention & control… more
    ChenMed (08/08/25)
    - Related Jobs
  • Medical Management Nurse

    Elevance Health (Miami, FL)
    …clinical guidelines and/or policies to evaluate medical necessity. + Works with healthcare providers to promote quality member outcomes, optimize member ... with leadership in enhancing training and orientation materials. + May complete quality audits and assist management with developing associated corrective action… more
    Elevance Health (08/23/25)
    - Related Jobs
  • Quality Assurance Specialist

    AssistRx (Orlando, FL)
    …uptake, visibility and outcomes. Our talented team members provide therapy and healthcare system expertise to help patients achieve better results from care. A ... scoring, and reporting as well as system data entry quality . Within this role, the Quality Assurance...Specialist regularly provides support to the department managers and director to effectively maintain program operations and goals. +… more
    AssistRx (08/12/25)
    - Related Jobs
  • Supplier Quality Engineer

    CACI International (Orlando, FL)
    …facility in Orlando, FL to, under minimal direction, manage several elements of the quality management system and other process quality initiatives to remain ... need and then administrate SCARs + Collaborate with the director , managers, and individual contributors within Manufacturing, Engineering and.../ Gemba Meetings + Experience with AS9100 and ISO Quality Management Systems - ** ** **What… more
    CACI International (07/29/25)
    - Related Jobs