• Director, Drug Trend and Pipeline Forecasting

    CenterWell (Tallahassee, FL)
    …potential market events that would drive unanticipated changes in cost and utilization . The team also leads our trend detection process, responsible for identifying ... month, quarter over quarter and year over year trend review and ad hoc as needed + Proactively monitors...time that is best for your schedule **Work at Home requirements:** To ensure Home or Hybrid… more
    CenterWell (05/11/25)
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  • Director of Physician Services

    HCA Healthcare (Tampa, FL)
    …protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, ... a 100% match on 3% to 9% of pay ( based on years of service) + Employee Stock Purchase...+ Referral services for child, elder and pet care, home and auto repair, event planning and more +… more
    HCA Healthcare (05/13/25)
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  • Associate Medical Director, Cardiology

    Evolent (Tallahassee, FL)
    …developing cardiovascular programs that include improvements to clinical effectiveness of utilization management (UM) and risk- based models.** + Process ... role in **Performance Suite risk arrangements with payers and strategic utilization management initiatives.** This is an opportunity for a **Cardiologist** to… more
    Evolent (03/04/25)
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  • RN Case Manager PRN

    HCA Healthcare (Ocala, FL)
    …issued card required within 30 days of start + Certification in Case Management or Utilization Review preferred + 2 years acute hospital RN experience required + ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care...a 100% match on 3% to 9% of pay ( based on years of service) + Employee Stock Purchase… more
    HCA Healthcare (03/04/25)
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  • RN case Mgr PRN

    HCA Healthcare (Margate, FL)
    …2 years of critical care experience + Certification in case management or utilization review preferred + InterQual experience preferred HCA Florida Northwest ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care...a 100% match on 3% to 9% of pay ( based on years of service) + Employee Stock Purchase… more
    HCA Healthcare (04/02/25)
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  • RN Case Manager PRN

    HCA Healthcare (Gainesville, FL)
    …is preferred + BSN is preferred + Certification in Case Management, Nursing or Utilization Review is preferred HCA Florida North Florida Hospital is a 523-bed, ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care...a 100% match on 3% to 9% of pay ( based on years of service) + Employee Stock Purchase… more
    HCA Healthcare (03/06/25)
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  • Medical Director - Medicare Grievances and Appeals…

    Humana (Tallahassee, FL)
    …of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Represents Humana at Administrative ... on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with health insurance organizations,… more
    Humana (05/14/25)
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  • Corporate Medical Director - Medicare Grievances…

    Humana (Tallahassee, FL)
    …first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate Medical Director works on ... on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with health insurance organizations,… more
    Humana (04/24/25)
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  • RN Case Manager Observation

    HCA Healthcare (Gainesville, FL)
    …protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, ... a 100% match on 3% to 9% of pay ( based on years of service) + Employee Stock Purchase...+ Referral services for child, elder and pet care, home and auto repair, event planning and more +… more
    HCA Healthcare (04/29/25)
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  • Pharmacy Buyer

    HCA Healthcare (Tallahassee, FL)
    …protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, ... a 100% match on 3% to 9% of pay ( based on years of service) + Employee Stock Purchase...+ Referral services for child, elder and pet care, home and auto repair, event planning and more +… more
    HCA Healthcare (02/20/25)
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