- AdventHealth (Orlando, FL)
- …inpatients and 125,000 outpatients each year **The role you'll contribute:** The Director of Clinical Outcomes is a registered professional nurse with comprehensive ... patients of specific age groups identified by the standards of care. The Director assures evaluation of clinical care processes and patient outcomes and directs… more
- Humana (Tallahassee, FL)
- …a part of our caring community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D & B). ... The Medical director work assignments involve moderately complex to complex issues...medical management review organization such as Medicare Advantage, managed Medicaid , or Commercial health insurance + Experience with national… more
- AdventHealth (Davenport, FL)
- …central hub of tourism. **The role you'll contribute:** The Care Management Facility Director has full accountability and oversight for the overall operations of the ... not limited to: Coordination of Care, Centers for Medicare & Medicaid Services (CMS) Conditions of Participation, Discharge Planning, Social Services, Readmission… more
- AdventHealth (Tampa, FL)
- …work life balance **The role you'll contribute:** The Care Management Facility Director has full accountability and oversight for the overall operations of the ... not limited to: Coordination of Care, Centers for Medicare & Medicaid Services (CMS) Conditions of Participation, Discharge Planning, Social Services, Readmission… more
- AdventHealth (Tampa, FL)
- **Basic Function** The Fellowship Program Director , in accordance with the specific accreditation body, has responsibility and accountability for the operation of ... well-being. + Oversight of scholarly activities The Fellowship Program Director reports to the Sponsoring Institution's Chief Academic Officer/Designated… more
- Lake Erie College of Osteopathic Medicine (Defuniak Springs, FL)
- Assistant Director of Patient Care Services - School of Dental Medicine Overview Date Posted: 7/30/2025 Location: LECOM Defuniak Springs Dental Clinic Address: 101 ... Full-time Description JOB SUMMARY: We are recruiting an Assistant Director of Patient Care Services for LECOM's Dental Outreach...with an understanding of dealing with and processing Florida Medicaid and Medicare; + Possess a strong sense of… more
- Humana (Miami, FL)
- …Advantage HMO plans that have been awarded 5-Star ratings by the Centers for Medicare and Medicaid Services in each of the past two years, and three of the past five ... a talented healthcare/health insurance leader for the role of Director , Provider Contracting. The Director will be...to help people with Medicare, or both Medicare and Medicaid , achieve their best possible health and wellness through… more
- Molina Healthcare (Orlando, FL)
- …improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare, ... Medicaid , NCQA and other regulatory requirements. + Reviews quality...including: + 2 years previous experience as a Medical Director in a clinical practice. + Current clinical knowledge.… more
- Elevance Health (Tampa, FL)
- **Clinical Documentation and Claims Integrity Director ** **Location:** Alternate locations may be considered. This position will work a hybrid model (remote and ... home-care and community based services. The **Clinical Document Improvement Director ** is responsible for leading encounter processing, diagnostic documentation and… more
- Humana (Tallahassee, FL)
- …our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. ... The Corporate Medical Director works on problems of diverse scope and complexity...+ Knowledge of the managed care industry including Medicare, Medicaid and/or Commercial products + Must be passionate about… more