- 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 ... The ideal candidate has experience working in leading healthcare payer claims / revenue cycle management (RCM) organizations, with specific understanding… more
- Molina Healthcare (Jacksonville, FL)
- …including 2 years in a manager role. * Experience reviewing all types of medical claims (eg CMS 1500, Outpatient/Inpatient, Universal Claims , Surgery, ... processed in accordance with local Health Plan requirements * Works with Claims , Configuration, Contracting, Provider Data Management , and other business… more
- USAA (Tampa, FL)
- …risks, and issues to stakeholders across multiple departments, including senior management , claims business partners, legal, and IT. Manage expectations ... development and implementation of multiple Data and Analytics sub-functions for Claims that may include: Information Strategy and Architecture, Information … more
- USAA (Tampa, FL)
- …what truly makes us special and impactful. **The Opportunity** As a dedicated Director of Business Process Ownership, you will oversee a team of business ... and development of business rules, gathering of requirements, artifacts and process management . Guide team members in the ownership of assigned processed to include,… more
- Amentum (Tallahassee, FL)
- …appropriate insurance coverage and risk mitigation strategies. + Lead complex claims management , including litigation strategy and resolution in coordination ... **Amentum seeks a Director , Insurance and Risk Management .** **Amentum**...sectors.** + Deep knowledge of insurance products, risk financing, claims management , and enterprise risk practices. +… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- …medicines for those with CNS disorders, we are seeking a skilled and experienced Medical Director of CNS Early Assets, Global Medical Affairs, responsible ... , Franchise Lead CNS Early Assets. **Position Summary:** The Medical Director , Global Medical Affairs,...for any assigned assets in development. + Support lifecycle management initiatives and planning for assigned assets as applicable.… more
- Humana (Tallahassee, FL)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Community Health Systems (Naples, FL)
- The **System Director of Risk Management ** is a key leader responsible for overseeing risk management , patient safety, and regulatory compliance across ... collaborate with one to support quality and safety initiatives. ** Claims & Litigation Management ** + Oversee legal...standards in patient safety and quality care The **System Director of Risk Management ** is a vital… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- **Job Summary** The Associate Director (AD), Commercial Data Management (CDM) within Data Enablement (DE) for Business Analysis (BA) is accountable for ... and utility of Otsuka's data assets. **Job Description** Reporting to the Director CDM, this role will be responsible for providing strategic insight and… more
- Humana (Tallahassee, FL)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more