- Humana (Tallahassee, FL)
- **Become 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... management review organization such as Medicare Advantage, managed Medicaid , or Commercial health insurance + Experience with national… more
- Humana (Tallahassee, FL)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and ... preservice appeals. The Corporate Medical Director works on problems of diverse...+ Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products + Must be passionate… more
- Humana (Tallahassee, FL)
- …lead Medical Directors performing utilization management for inpatient authorizations training medical director team to assist and facilitate new hires and ... look at appeals rate with denials and overturns. Deliver the upmost consistent medical director decision making. + _Internal Operations and Technology_ _:_… 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 ... CarePlus is seeking a talented healthcare/health insurance leader for the role of Director , Provider Contracting. The Director will be responsible for all… more
- BrightSpring Health Services (Gainesville, FL)
- Our Company ResCare Community Living Overview The Assistant Director of Nursing is responsible for assisting the Director of Nursing with the daily performance ... performance of the unit. Responsibilities + Coordinates with and assists the Director of Nursing with planning, coordinating, delivering, and overseeing the delivery… 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 Associate Director , Learning Design uses instructional design, cognitive psychology and adult learning theory ... solution to a knowledge or performance gap. The Associate Director , Learning Design requires a solid understanding of how...**What Humana Offers** We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company… more
- Humana (Tallahassee, FL)
- …of our caring community and help us put health first** The Associate Director , Business Intelligence solves complex business problems and issues using data from ... and external sources to provide insight to decision-makers. The Associate Director , Business Intelligence requires a solid understanding of how organization… more
- Elevance Health (Tampa, FL)
- **CareBridge Growth Director ** **Location:** Alternate locations may be considered. This position will work a hybrid model ( remote and office). The ideal ... quality of life through home-care and community based services. The CareBridge Growth Director will function as a Chief of Staff, overseeing key initiatives to drive… more
- Humana (Tallahassee, FL)
- …and help us put health first** We're looking for an experienced and passionate Associate Director of AI Engineering to lead a team focused on building the agentic AI ... to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be… more