- Highmark Health (Tallahassee, FL)
- …current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and ... RESPONSIBILITIES** + Conduct electronic review of escalated cases against medical policy criteria, which may include telephonic peer to...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- The Cigna Group (Tallahassee, FL)
- …one of your employment, you'll be offered several health-related benefits including medical , vision, dental, and well-being and behavioral health programs. We ... race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender… more
- Elevance Health (FL)
- **JR139707 Behavioral Health/EAP Consultant II** The ** Behavioral Health EAP Consultant II** (Wellbeing Support Consultant-WSC) has the primary responsibility of ... & Inclusion, and other Employee Relations groups as needed. The onsite Behavioral Health/EAP Consultant II position, although onsite, is currently in hybrid status… more
- Monte Nido (Miami, FL)
- …lives while providing the opportunity for people to realize their healthy selves. ** Director of Payor Contracting** **Monte Nido** ** Remote ** Monte Nido is a ... expertise, and a commitment to clinical excellence. **Position Summary** The Director of Payor Contracting is responsible for leading the negotiation,… more
- CenterWell (Tallahassee, FL)
- …our caring community and help us put health first** The Divisional Director is responsible for building a strong partnership with clinical-operational divisional ... to reduce acute and post-acute care utilization. The Divisional Director role is a hybrid with travel requirements to...Lead + Market President + Market CMO + Regional Medical Directors + VP CIO Care Delivery + VP,… more
- Cognizant (Tallahassee, FL)
- **Title: Director , Strategic Product Management (Life Sciences Products & Platform)** **Location: Remote ** **Job ID: 00061957061** **Build a Meaningful Career ... to meet revenue targets as well as develop partnerships. **Job Title: Director , Strategic Product Management (Life Sciences Products & Platform)** **Role: People… more
- Humana (Tallahassee, FL)
- …of our caring community and help us put health first** The Director , Risk Adjustment Strategy Advancement will provide business intelligence and strategic planning ... support for business segments and the company at large. The Director , Risk Adjustment Strategy Advancement requires an in-depth understanding of how organization… more
- AdventHealth (Altamonte Springs, FL)
- …**together** we are even better. **Shift** : Full-time; Monday-Friday **Job Location** : Remote **The role you will contribute:** Under general supervision of the ... Director of Clinical Documentation Integrity and in some situations.... Demonstrates extending the healing ministry of Christ, through behavioral whole care standards of love me, make it… more
- Centene Corporation (Tallahassee, FL)
- …on best practice models and utilization management processes + Interact with the Medical Director , or designee, to discuss clinical authorization questions and ... for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering… more
- Veterans Affairs, Veterans Health Administration (Tampa, FL)
- …of Staff and serves as a key clinical resource for the Healthcare System Director and Chief of Staff. The DCOS's responsibilities include serving as the lead ... physician over Ambulatory Care, Mental Health & Behavioral Science, Spinal Cord Injury, Dental, Geriatrics and Extended...key advisor to the Chief of Staff (COS) and Director on clinical issues and assists in the administration… more