- Sedgwick (Tallahassee, FL)
- …Fortune Best Workplaces in Financial Services & Insurance Sr. VP Medical Director **PRIMARY PURPOSE** **:** To evaluate medical reports escalated due to deficient ... required to include one (1) to three (3) years utilization review experience and three (3) years clinical quality...+ Knowledge about general claim practices. + Knowledge of pharmacy processes and pharmacy benefit management a… 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, combining ... in patient experience, quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify opportunities in care,… more
- CenterWell (Daytona Beach, FL)
- …and help us put health first** Job Description Summary The Associate Medical Director (AMD) is an instrumental clinical leader of our primary care team, combining ... in patient experience, quality of care, clinical outcomes, and avoidable utilization *Periodically review clinician charts to identify opportunities in care,… more
- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- IT Director - Infrastructure & Support Job Details Job Location Polaris Pharmacy Services of Ft Lauderdale - Ft. Lauderdale, FL Remote Type Hybrid Position Type ... Job Shift Day Description Job Summary: As an IT Director , you will be responsible for overseeing the company's...lessons learned. + Process Improvement + Optimize Azure Cloud utilization and expense. + Identify and implement process improvements… more
- Prime Therapeutics (Tallahassee, FL)
- …fuels our passion and drives every decision we make. **Job Posting Title** Sr. Director Actuarial Forecasting - REMOTE **Job Description** The Senior Director of ... functional leadership to develop and maintain projected trend assumptions related to utilization , unit cost, and gross/net rebate assumptions + Owns the annual… more
- CVS Health (Tallahassee, FL)
- …Pharmacy , Member Outreach, Care Management, National Quality Management, Utilization Management, Compliance, and other departments to integrate social, ... outcomes. * Leverage extensive knowledge of health care delivery system, utilization management, reimbursement methods and treatment protocols for DSNP/MMP and other… more
- United Site Services (Orlando, FL)
- …and excellence in every aspect of our business. **Primary Purpose** The Director , National Fence Operations is a key strategic leader responsible for scaling ... dispersed teams with a focus on accountability, servicequality, and asset utilization + Strong knowledge of operational planning, inventory control, and logistics… more
- Travelers Insurance Company (Tallahassee, FL)
- …collaboration with the Claim leaders and in partnership with other Medical and Pharmacy professionals. **What Will You Do?** + Provide overall program leadership as ... sustain quality results. + Partner with other medical and pharmacy experts on the development and design of training...Have?** + Licensed MD + 5 years clinical and utilization management experience + Certified by the American Board… more
- MTC (Quincy, FL)
- …the duties of the position. 11. Practice advanced cost containment and utilization management for inmate care and facility operations. 12. Maintain absolute security ... determine all provided services are documented. 14. Closely monitor illnesses. 15. Audit pharmacy use for adherence to formulary and compliance with all pharmacy … more
- Highmark Health (Tallahassee, FL)
- …Drug Formularies by monitoring FDA-approvals and drug manufacturer pipelines, assessing drug utilization reports, and writing drug monographs for Pharmacy & ... overall efficiencies. + Manage individual projects for timely review with the Director , Clinical Pharmacy . + Participate in Medicare Stars performance measures… more