- Humana (Tallahassee, FL)
- …focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with health ... 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… more
- University of Miami (Hialeah, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Manager, ... a Full Time Manager, Supply Chain Asset Management to work in the UHealth Medical Campus. Core Job Summary The Asset Management Manager is responsible for managing… more
- Fresenius Medical Center (Tampa, FL)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. ... a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in...+ Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. +… more
- Cognizant (Tallahassee, FL)
- …guidelines and regulations + Experience in the analysis and processing of claims, utilization review /quality assurance procedures + Must be able to work with ... Based** Claims Processors to join our growing team. The ** Medical ** **Claims Processor** is responsible for the timely and...HCFA paper, or EDI information. + Responsible for reviewing medical records when necessary to determine if the service… more
- Fresenius Medical Center (Venice, FL)
- …communicated to and implemented by the facility staff. + Maintains integrity of medical records and other FMS administrative and operational records. + Complies with ... as pertinent. **STAFF:** + Responsible for implementation of FMS staffing, and medical supply models, to provide quality patient care, and makes recommendations. +… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …+ Participate in interdisciplinary case rounds, quality improvement initiatives, and utilization review processes. + Support members during transitions of ... behavioral/mental health + Experience in a managed care, case management, or utilization review setting + Strong understanding of behavioral health diagnoses,… more
- MyFlorida (Tallahassee, FL)
- MEDICAL /HEALTH CARE PROG ANALYST - SES - 64055877 Date: Aug 14, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... . Requisition No: 858520 Agency: Department of Health Working Title: MEDICAL /HEALTH CARE PROG ANALYST - SES - 64055877 Pay Plan: SES… more
- Surgery Care Affiliates (Tallahassee, FL)
- …package to support your health, well-being, and financial future. Our offerings include medical , dental, and vision coverage, 401k plan with company match, paid time ... and Communication. + Informs executive leadership about current trends, problems, and medical activities to facilitate policy making. + Establish and secure approval… more
- CenterWell (The Villages, FL)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... delivery, and documentation requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance … more
- AssistRx (Orlando, FL)
- …for the creation, design, set-up and administration of Pharmacy and Medical Copay programs for AssistRx manufacturer clients. Required engagement with client, ... and provide ongoing Copay program metrics for internal and external business review meetings. Responsible for forecasts and analyzing claims data to determine Copay… more