• Medical Director Physician Advisor UM

    AdventHealth (Altamonte Springs, FL)
    …- Physician + Board certified and eligible for membership on the Hospital medical staff ** Preferred Qualifications:** + Master's in Business or Healthcare ... as a liaison between UM and CM teams and medical staff, as well as, the medical ...shares observations, information and trends identified through data and case reviews + Conducts regular, ongoing meetings with Care… more
    AdventHealth (08/07/25)
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  • Associate Medical Director, PVRM

    Sumitomo Pharma (Tallahassee, FL)
    …FDA and/or EU ICH safety requirements** + Expertise in medical review of medical review of Individual case safety reports and aggregate safety reports + ... dynamic, highly motivated, and experienced individual for the position of **Associate Medical Director.** The Associate Medical Director will provide hands-on… more
    Sumitomo Pharma (08/02/25)
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  • Acute Care Manager, Complex Care (Registered…

    ChenMed (Pembroke Pines, FL)
    …to preferred providers. + Coordinate the integration of social services/ case management functions in the pre-acute, ER, acute and post-acute setting. Coordinate ... departments, and other healthcare facilities. + In conjunction with the PCP, hospitalist, Medical Director of Transitional Care, insurance case manager and the… more
    ChenMed (08/16/25)
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  • Medical Director -Pharmacy Appeals

    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...where the analysis of situations or data requires a case -by- case consideration of the Medicare rules, Humana… more
    Humana (08/22/25)
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  • Admissions Coordinator

    Select Medical (Miami, FL)
    …a broad range of duties with an Admissions or Pre-Admissions Department required. ** Preferred Experience** + Knowledge of Medical terminology preferred + ... **Overview** **West Gables Rehabilitation Hospital** A joint venture with Select Medical & West Gables **Admissions Coordinator** **Tuesday - Saturday 9:30am - 6pm**… more
    Select Medical (07/03/25)
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  • Human Services Program Consultant II

    MyFlorida (Orlando, FL)
    …can substitute 6 months of direct case management experience. + Completion of Medical Case Management AETC Southeast AIDS Education course within 30 days of ... assessments and home visits. + Current HIV 500/501 certification. + Current Medical Case Management AETC Southeast AIDS Education certification. Florida… more
    MyFlorida (07/08/25)
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  • Underwriting Manager ( Medical Insurance)

    CVS Health (Tallahassee, FL)
    …Lead team meetings and serve as the first point of contact for complex case issues or challenges. + Support hiring, onboarding, and ongoing talent development of ... + Build and maintain relationships with stop loss carriers to support case resolution and negotiation efforts. + Clearly articulate Meritain's services, underwriting… more
    CVS Health (07/02/25)
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  • Medical Social Worker

    BayCare Health System (Riverview, FL)
    …4:30 PM + **Weekend Requirement:** Every + **On Call:** No **Certifications and Licensures:** + Preferred ACM ( Case Management) or + Preferred CCM ( Case ... dignity, respect, responsibility and clinical excellence. **The Social Services Specialist I/ Medical Social Worker responsibilities include:** + Being a member of a… more
    BayCare Health System (07/15/25)
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  • Medical Social Worker

    BayCare Health System (Wesley Chapel, FL)
    …PM + **Weekend requirement:** Occasional + **On Call:** No **Certifications and Licensures:** + Preferred ACM ( Case Management) or + Preferred CCM ( Case ... + Required Masters in Social Work, Sociology, or Related Field + Strongly Preferred Masters Degree in Social Work **Experience:** + Required 6 months Internship or… more
    BayCare Health System (06/04/25)
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  • Associate Medical Director - Orthopedic…

    Elevance Health (Tampa, FL)
    **Clinical Operations Associate Medical Director** **Orthopedic Spine Surgery** **Carelon Medical Benefit Management** **Schedule: 10:30 AM-7 PM Central** ... is granted as required by law._ The **Clinical Operations Associate Medical Director - Orthopedic Spine Surgery** is responsible for performing pre-authorizations… more
    Elevance Health (08/02/25)
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