- Molina Healthcare (Orlando, FL)
- …HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization/Quality Program management + Previous ... Assists in recruitment, hiring and training of staff as needed. + Analyzes data and identifies medical cost savings and quality improvement opportunities. + Accounts… more
- WTW (Tampa, FL)
- **Description** As a Health and Benefits Financial/Actuarial Director , you will serve as the financial lead for large, complex client assignments. You'll leverage ... design and innovative financial solutions. You will apply your financial management and data analytics expertise to solve complex client problems and to lead the… more
- CVS Health (Tallahassee, FL)
- …Familiarity with data science and machine learning concepts, particularly in healthcare applications. + Experience collaborating with data science teams or ... seeking a strategic and technically proficient leader to oversee Medicare data science initiatives supporting actuarial analytics and pricing. The ideal candidate… more
- Molina Healthcare (Miami, FL)
- …delegation oversight committees. * Liaison to Special Investigative Unit regarding program integrity and oversight cost expenditure. * Monitor internal compliance of ... Corporate Operations units via establishment of an internal compliance program , including annual, periodic, focal, etc. audits. * Request, review and perform… more
- Molina Healthcare (Orlando, FL)
- …across the enterprise. Designs and delivers metrics and measurements supporting program evolution and validation. + Develops and maintains the PSOC's policies, ... leadership and methodologies to solve analytical problems when raw unfinished data contains information gaps and requires validation. + Implements processes,… more
- Molina Healthcare (Tampa, FL)
- …processes are established. Develops and performs internal audits/risk assessments, monitoring program for Molina Healthcare departments. Provides post audit ... the management of the benefits, operations, communication, reporting, and data exchange of the Medicare product in support of...policies and procedures for the Medicare and Dual Eligible Program and participates in the strategic development of its… more
- Molina Healthcare (St. Petersburg, FL)
- …include internal and external reporting requirements. * Reviews and analyzes, collects data along with audit results on unit's performance; analyzes and interprets ... of Medicare experience **Required Experience** * 7 years experience in healthcare claims review and/or member appeals and grievance processing/resolution, including… more
- University of Florida (Gainesville, FL)
- …of data -driven implementation strategies that improve patient outcomes and healthcare delivery systems. The Director will be responsible for generating ... Research Associate Professor & Director of Implementation Science and Outcomes Evaluation Apply...strategy aimed at translating evidence-based research into nursing and healthcare practices. + Data -Driven Decision Making (5%):… more
- Grifols Shared Services North America, Inc (Sarasota, FL)
- Would you like to join an international team working to improve the future of healthcare ? Do you want to enhance the lives of millions of people? Grifols is a global ... healthcare company that since 1909 has been working to...and regions. The primary responsibility of the MSL Field Director is the management, performance, and coaching of a… more
- Sumitomo Pharma (Tallahassee, FL)
- …support program & HUB operations supporting the rare disease product(s). The Director leads the design and execution of program operations, systems, metrics, ... seeking a dynamic, highly motivated, and experienced individual for the position of ** Director , Patient & HUB Operations, Rare Disease** . The Director , Patient… more