- CVS Health (Tallahassee, FL)
- …more compassionate. And we do it all with heart, each and every day. The Lead Director, National VBC Performance Planning & Insights will act as a strategic leader ... the development and tracking of performance improvement programs and lead executive-level reporting and performance reviews **VBC Performance Reporting** +… more
- CVS Health (Tallahassee, FL)
- …is accountable for the strategic alignment, operational success, and performance management of assigned provider relationships with the most complex/high value ... initiatives and/or highest risk and revenue generating provider systems, network and value-based...that reside in Georgia.** **Key Responsibilities:** + Provider Relationship Management - Understands the terms of the value-based contract… more
- Eliassen Group (Tallahassee, FL)
- …of companies reach further and achieve more with their technology solutions, financial, risk & compliance, and advisory solutions, and clinical solutions. With ... ** Lead Varicent ICM Developer** **Anywhere** **Type:** Contract **Category:**...design, configuration, and implementation of the Varicent Incentive Compensation Management (ICM) platform. This role will work closely with… more
- ChenMed (Miami, FL)
- …and we need great people to join our team. The Lead , Provider Enrollment Coordinator is responsible managing/overseeing ChenMed's third-party provider enrollment ... the primary point of contact to work with Legal, Risk , Compliance and Billing departments to ensure seamless submission...primary point of contact for PCP recruiters on providing clinical ready effective dates for incoming providers. + Compiles… more
- Carnival Cruise Line (Miami, FL)
- …+ **Crew Medical Claims Management ** + Escalate high- risk crew cases to risk management , legal, HR, and clinical governance teams. + Review crew ... and employing over 160,000 crew members. **Essential Functions:** + Case Management Oversight + Manage high-complexity cases involving clinical challenges,… more
- Carnival Cruise Line (Miami, FL)
- …and escalate to the attention of risk management and the case management (MD), clinical governance, legal, and HR teams. + Review crew claims for ... and their families with professionalism and empathy. + Review clinical care plans for appropriateness and support the case...per International Maritime Health guidelines. + **Crew Medical Claims Management ** + Review crew cases of high risk… more
- ChenMed (Largo, FL)
- …their healthy time at home. The Intensive Community Managers (ICCMs) will serve as a clinical lead for the Complex Care Team. They will assess, evaluate, and ... Nurse (RN) Community Care Nurse will serve as a clinical lead for a Community Care team....need and to oversee appropriate patient discharge from case management . + Performs clinical , fall prevention, and… more
- University of Miami (Miami, FL)
- …automation systems monitoring. + Develop and implement enterprise-wide energy management strategies aligned with clinical priorities, sustainability goals, ... tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Executive Director, Utilities and Energy Management The University of Miami/UHealth department of Facilities has… more
- Molina Healthcare (Tampa, FL)
- …Professional in Health Care Quality (CPHQ) or other health care or management certification. + Medicaid/Medicare population experience. + Clinical experience. + ... professionals in some or all of the following functions: care management , utilization management , behavioral health, care transitions, long-term services… more
- Humana (Tallahassee, FL)
- …policy technologies. Manage project prioritization, resource allocation, and risk management to optimize outcomes. + Lead financial planning, forecasting, ... help us put health first** Job Description Summary: The Senior IT Portfolio Management Professional is responsible for aligning the IT portfolio and demand with the… more