- Humana (Tallahassee, FL)
- …topics to the clinical operations team and healthcare organization. The Medical Director 's work includes computer based review of moderately complex to ... and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health...conferences, and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare… more
- Humana (Tallahassee, FL)
- …a part of our caring community and help us 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...represents Humana at Administrative Law Judge hearings; exercises independent clinical judgment and decision making on complex issues regarding… 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...+ Excellent communication skills + 5 years of established clinical experience + Knowledge of the managed care industry… more
- Molina Healthcare (Orlando, FL)
- …3+ years HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization/Quality Program management + ... Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and… more
- CVS Health (Tallahassee, FL)
- …/ Appeal Hearings / Special Projects and Committee participation when needed. The Medical Director will provide clinical , coding, and reimbursement expertise ... / Pediatrics (Med / Peds) Board Certification. In the Medical Director role, you will provide oversight...directing case management when necessary. The Medical Director will act as a business and clinical… more
- Aveanna Healthcare (Tampa, FL)
- RN Clinical Director ApplyRefer a FriendBack Job Details Requisition #: 204579 Location: Tampa, FL 33607 Category: Nursing Salary: $78,000.00 - $82,000.00 per ... year Position Details Position: Clinical Director (RN) ( Director of...children, adolescents, and/or adults. Note: As an employer receiving Medicare and Medicaid funds, Aveanna employees must comply with… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- ChenMed (Hallandale Beach, FL)
- …preferred. + Strongly prefer one (1) years' previous experience as Medical Director or equivalent with a Medicare or Medicaid patient population + Board ... great people to join our team. The Associate Market Clinical Director will directly supervise, performance manage...to be an existing high performing PCP partner and/or Medical Director within the ChenMed core model,… 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 ... and quality of life through home-care and community based services. The ** Clinical Document Improvement Director ** is responsible for leading encounter… more
- Humana (Tallahassee, FL)
- …of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home ... DME, dual Medicare /Medicaid and Waiver requests. The Medical Director provides medical interpretation...clinical standards, and (in some cases) contracts. The Medical Director provides medical interpretation… more