- AssistRx (Orlando, FL)
- …skills. + . Thorough understanding of pharmaceutical copay structures - pharmacy and medical, including benefit design, reimbursement systems , and financial ... Program Leadership & Strategy: + Lead the development, implementation, and optimization of pharmacy and medical copay assistance programs to ensure patient… more
- Molina Healthcare (St. Petersburg, FL)
- …compliance by owning Molina's entire CMS Complaints Tracking Module (CTM) life cycle. As Director of CTM Oversight & Resolution you set the standards and ... Enrollment, Claims, Pharmacy /PDE, Network, Stars quality metrics. * Proven record of closing process gaps and delivering durable improvements in a matrixed or… more
- Mayo Clinic (Jacksonville, FL)
- …Jacksonville, Florida is seeking an experienced Sleep Medicine physician to serve as Medical Director of the Sleep Center and deliver world class care to complex ... multiple departments including Pulmonary, Neurology, Nursing, Allied Health, and Pharmacy + Commitment to Mayo Clinic RICH TIES values:...should expect the following:** + Function as the Medical Director of the Sleep Medicine Service Line… more
- Evolent (Tallahassee, FL)
- …conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level ... leadership relationships and driving clinical/operational change + Strong understanding of value-based care, healthcare delivery systems , and payment… more
- Molina Healthcare (Orlando, FL)
- …between administration and medical staff. Assures the ongoing development and implementation of policies and procedures that guide and support the provisions of ... Provides medical oversight and expertise in appropriateness and medical necessity of healthcare services provided to members, targeting improvements in efficiency… more
- CVS Health (Tallahassee, FL)
- …the populations managed to improve health outcomes. * Leverage extensive knowledge of health care delivery system , utilization management, reimbursement methods ... At CVS Health, we're building a world of health around every consumer and surrounding ourselves...cost-efficient care. Will also interact with the members, health systems , nursing facilities, as well as home and community-based… more
- CenterWell (Tallahassee, FL)
- …SLAs and manage KPI and metrics performance + Support and/or lead the implementation of process, procedure and systems to drive value in the Centralized Billing ... caring community and help us put health first** Associate Director will lead the Revenue Cycle Management team for...primary care, one of the largest providers of home health services, and fourth largest pharmacy… more
- CenterWell (Jacksonville, FL)
- …of our caring community and help us put health first** The Associate Medical Director (AMD) is an instrumental clinical leader of our primary care team, ... of care opportunities from both individual, team, and systems perspectives and partner with clinical and operational colleagues...primary care, one of the largest providers of home health services, and fourth largest pharmacy… more
- CenterWell (Daytona Beach, FL)
- …community and help us put health first** Job Description Summary The Associate Medical Director (AMD) is an instrumental clinical leader of our primary care ... of care opportunities from both individual, team, and systems perspectives and partner with clinical and operational colleagues...primary care, one of the largest providers of home health services, and fourth largest pharmacy… more
- Sedgwick (Tallahassee, FL)
- … state's jurisdiction/ERISA regulations + Knowledge about general claim practices. + Knowledge of pharmacy processes and pharmacy benefit management a plus. ... Workplaces in Financial Services & Insurance Sr. VP Medical Director **PRIMARY PURPOSE** **:** To evaluate medical reports escalated...Knowledge of utilization review procedures + Knowledge of clinical quality systems and measurements +… more