- Elevance Health (Miami, FL)
- …to their supervisors attention, any case review decisions that require + Medical Director review or policy interpretation. **Minimum Requirements:** + ... **Clinical Operations Associate Medical Director ** **Carelon Medical Benefits Management** **Radiology Benefit** **Management/ Utilization ** ** Review… more
- University of Miami (Miami, FL)
- …and reporting functionally to the Chief Nursing Officer for UHealth, and Chief Medical Director of Oncology Services, the Executive Director , Oncology ... Full Time Executive Director , Clinical Operations to work at the UHealth medical campus in Miami, FL. CORE JOB SUMMARYThe Executive Director , Clinical… more
- CVS Health (Tallahassee, FL)
- …ensuring timely and consistent responses to members and providers. As a Medical Director you will focus primarily on review appeal cases for denied ... have Internal Medicine or Internal Medicine/Pediatrics (Med/Peds) Board Certification. In the Medical Director role, you will provide oversight for medical… more
- CVS Health (Tallahassee, FL)
- …a Medical Director you will + Focus primarily on overseeing utilization review / quality assurance and be responsible for predetermination reviews and ... their clinical quality and effective use of health care resources. In the Medical Director role you will + Provide oversight for medical policy… more
- Humana (Tallahassee, FL)
- …put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate ... Medical Director works on problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with… more
- Elevance Health (Tampa, FL)
- **Clinical Operations Associate Medical Director ** **Orthopedic Spine Surgery** **Carelon Medical Benefit Management** **Schedule: 10:30 AM-7 PM Central** ... an accommodation is granted as required by law._ The **Clinical Operations Associate Medical Director - Orthopedic Spine Surgery** is responsible for performing… more
- Florida Health Care Plans, Inc. (Daytona Beach, FL)
- …social and emotional factors underlying patient's health problem. ? Monitors ongoing training, utilization review and peer review for clinical Providers ... of mental health services within a community. The Behavioral Health Director will be responsible for overseeing clinical operations, implementing quality improvement… more
- Molina Healthcare (Orlando, FL)
- …Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization /Quality Program management + Previous ... Supervises and manages Medical Directors + Develops medical policies and procedures + Conducts peer review... medical policies and procedures + Conducts peer review **JOB QUALIFICATIONS** **REQUIRED EDUCATION:** * Doctorate Degree in… more
- CVS Health (Jacksonville, FL)
- …anywhere in the US.** Aetna, a CVS Health Company, has an exciting opportunity for a Medical Director (Spine) that can be remote based, work from home. The ... Medical Director (Spine) will be a Subject...responses to members and providers. Leads all aspects of utilization review /quality assurance, directing case management Provides… more
- Evolent (Tallahassee, FL)
- …Stay for the culture. **What You'll Be Doing:** Evolent is seeking an **Associate Medical Director - Cardiovascular Medicine** to play a critical role in ... improving healthcare quality.** + **Computer proficiency** and ability to navigate electronic medical review platforms. + No current exclusions, sanctions, or… more