- AdventHealth (Altamonte Springs, FL)
- …the Physician Advisor is responsible for providing clinical review of utilization, claims management , and quality assurance related to inpatient care, outpatient ... providing clinical expertise and business direction in support of medical management programs, promoting the delivery of...and submitting clinical denial appeals, as needed + Develops Medical Director relationships with payors to have… more
- Centene Corporation (Tallahassee, FL)
- …the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit. + ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a...performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals… more
- Humana (Tallahassee, FL)
- …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...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with… more
- Molina Healthcare (Orlando, FL)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Sedgwick (Tallahassee, FL)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr. VP Medical Director **PRIMARY PURPOSE** **:** To evaluate medical reports ... service requirements and assure efficient, cost effective, quality program delivery for medical and disability management . + Coordinating and evaluating the… more
- CenterWell (Tallahassee, FL)
- …EMR/PM systems. + Maintain Standard Operations Procedures for RCM functions: claims management , accounts receivable follow-up, internal collections, collection ... caring community and help us put health first** Associate Director will lead the Revenue Cycle Management ...RCM integration responsibilities for Mergers and Acquisitions and DeNovo medical centers + Collaborate closely with all departments in… more
- Wounded Warrior Project (Jacksonville, FL)
- …veterans' benefits or advocacy. + Three years of experience utilizing VA claims technologies (eg, Veterans Benefits Management System, Caseflow, Direct Upload) ... the office, two days' work from home) . Full medical , dental, and vision coverage for both teammates AND...for you. The Wounded Warrior Project (WWP) National Service Director leads and develops a team of benefits professionals… more
- HCA Healthcare (Palm Harbor, FL)
- …coding. + Report and manage IET's and Claims on Hold, Encounters without Claims in conjunction with Practice management . + Regularly review A/R data and ... over 156,000 hours volunteering in our communities. As a Director of Revenue with HCA Healthcare you can be...colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- …medicine and/or clinical pharmacology and associated disciplines (eg biostatistics, data management , medical writing). + An advanced understanding of clinical ... in support of domestic and international clinical development initiatives. The Senior Director , GCD works in a multidisciplinary matrix environment and supports the… more
- Marriott (Tampa, FL)
- …**Schedule** Full Time **Located Remotely?** N **Position Type** Management **JOB SUMMARY** Assists the Director of ... control risk. * Reports any procedure violations to the Director of Loss Prevention and appropriate management ....OSHA programs and statistical data. * Assists in the management of claims by ensuring proper procedures… more