• Operations Senior Analyst - EviCore…

    The Cigna Group (Tallahassee, FL)
    …to manage new and existing workflows. Monitors overall operations including review of internal reports and ad-hoc data analysis associated with operational ... enhance operational performance. **RESPONSIBILITIES** * Gains an understanding for utilization management, claims operations, IT operations, and call center… more
    The Cigna Group (08/14/25)
    - Related Jobs
  • Disease Management Nurse - Remote

    Sharecare (Tallahassee, FL)
    …techniques, the nurse helps to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also ... in the orientation and to take the pre and post tests to review competency during orientation. Yearly competency tests are required for all Sharecare clinicians.… more
    Sharecare (08/13/25)
    - Related Jobs
  • Manager Software Engineering - US Remote

    Anywhere Real Estate (Miami, FL)
    …problems; + Work with the Engineering team to conduct design and peer code review ; + Acquire knowledge of existing systems and the underlying business processes they ... customers, analysts, data scientists, and operations teams which will increase the utilization of our products and achieve competitive advantage; + Remain abreast of… more
    Anywhere Real Estate (08/08/25)
    - Related Jobs
  • Senior Analyst, Healthcare Analytics (Risk…

    Molina Healthcare (St. Petersburg, FL)
    …requestors to ensure appropriate creation of reports and analyses. Uses peer-to-peer review process and end-user consultation to reduce errors and rework + Practice ... + Demonstrate Healthcare experience in Quantifying, Measuring and Analyzing Financial and Utilization Metrics of Healthcare + Advanced knowledge of SQL + Proficient… more
    Molina Healthcare (07/17/25)
    - Related Jobs
  • Medical Director

    Centene Corporation (Tallahassee, FL)
    …management, cost containment, and medical quality improvement activities. + Performs medical review activities pertaining to utilization review , quality ... with respect to clinical issues and policies. + Identifies utilization review studies and evaluates adverse trends...plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay… more
    Centene Corporation (07/19/25)
    - Related Jobs
  • Group Manager - Operations Excellence

    Amentum (Kennedy Space Center, FL)
    …Asset Management principles and continuous improvements through best practices and utilization of Maximo, provide data base administration, software enhancements and ... testing, training, and implementation of major software upgrades. + COMET Facility Utilization Management (DFUM) group that assess space utilization requests,… more
    Amentum (07/12/25)
    - Related Jobs
  • Medical Director- South Central

    Humana (Tallahassee, FL)
    …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all… more
    Humana (07/11/25)
    - Related Jobs
  • Senior Guidewire Developer - BillingCenter

    Kemper (Jacksonville, FL)
    Location(s) Remote -AL, Remote -CT, Remote -FL, Remote -GA, Remote -IL, Remote -IN, Remote -MI, Remote -NC, Remote -OH, Remote -PA, ... complex technical problems and issues with assigned applications and work processes. + Review and recommend test plans for impacted areas and end to end test… more
    Kemper (08/07/25)
    - Related Jobs
  • Utlization Management Administration Coordinator…

    CenterWell (Tallahassee, FL)
    …member service or customer service telephone experience desired + Experience with Utilization Review and/or Prior Authorization, preferably within a managed care ... a part of our caring community and help us put health first** Utilization Management Administration Coordinator II , non-clinical, supports the UM operations by… more
    CenterWell (08/13/25)
    - Related Jobs
  • Clinical Health Services Associate Manager

    CVS Health (Tallahassee, FL)
    …And we do it all with heart, each and every day. **Position Summary** Fully remote , Monday-Friday 8am - 5pm EST position (shifts may vary based on business needs) ... level. The Associate Manager is also responsible for oversight of utilization management nurses including the organization and development of high performing… more
    CVS Health (08/08/25)
    - Related Jobs