- Humana (Tallahassee, FL)
- …industry including Medicare Advantage and Managed Medicaid products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health ... other healthcare providers, clinical group practice management + Utilization management experience in a medical management review organization,… more
- AdventHealth (Altamonte Springs, FL)
- …matter expert, providing clinical expertise and business direction in support of medical management programs, promoting the delivery of high quality, patient ... Management teams + Provides education and serves as a resource to Medical Staff colleagues regarding best practices, Utilization Management and Care … more
- Humana (Tallahassee, FL)
- …Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health ... other healthcare providers, clinical group practice management . + Utilization management experience in a medical management review organization,… more
- Elevance Health (Miami, FL)
- …people we serve. The medical director supports product strategy/design through medical management that impact health care quality, cost, and outcomes, and ... Director** is responsible for serving as the Operational Medical Director for our care management models...the clinical relevance to account reporting regarding use of medical services by members. Involved in identifying… more
- Centene Corporation (Tallahassee, FL)
- …changes everything for our 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national ... Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions... medical review of complex, controversial, or experimental medical services , ensuring timely and quality decision… more
- AdventHealth (Tampa, FL)
- …matter expert, providing clinical expertise and business direction in support of medical management programs, promoting the delivery of high quality, patient ... Care Management teams Provides education and serves as a resource to Medical Staff colleagues regarding best practices, Utilization Management and Care … more
- Travelers Insurance Company (Tallahassee, FL)
- … capabilities to keep Travelers at the leading edge of the P&C industry. Develop medical management strategies that help injured employees return to work as soon ... **What Is the Opportunity?** Lead the strategy and operations of Travelers Claim Medical initiatives focusing on how developments in the broader medical … more
- Molina Healthcare (FL)
- …provider reimbursement changes + Provide data driven analytics to Finance, Claims, Medical Management , Network, and other departments to enable critical decision ... Analysis projects related to medical cost reduction initiatives + Support Medical Management by assisting with Return on Investment (ROI) analyses for… more
- Molina Healthcare (FL)
- …provider reimbursement changes + Provide data driven analytics to Finance, Claims, Medical Management , Network, and other departments to enable critical decision ... related to medical cost reduction initiatives and budgeting same + Support Medical Management by assisting with Return on Investment (ROI) analyses for… more
- The Cigna Group (Fort Lauderdale, FL)
- …limited to, Claims Operations, Medical Management . Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing and Service . + Contributes to ... or visit Providers 3 days per week The **Manager, Provider Contracting Network Management ** serves as an integral member of the Provider Contracting Team and reports… more