- Highmark Health (Tallahassee, FL)
- …URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care. + ... care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care… more
- Elevance Health (Miami, FL)
- **Clinical Operations Medical Director ** **Carelon Medical Benefit Management ** **Radiation Oncology** **Virtual:** This role enables associates to work ... **Clinical Operations Medical Director ** is responsible for supporting the medical management staff ensuring timely and consistent medical decisions… more
- Humana (Tallahassee, FL)
- …reports to the Lead Medical Director . **Other duties:** + Identify medical management operational improvements, including those within the medical ... part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home… more
- Elevance Health (FL)
- …**Clinical Operations Medical Director ** is responsible for supporting the medical management staff ensuring timely and consistent medical decisions ... **Clinical Operations Medical Director ** ** Medical Oncology** **Carelon Medical Benefit Management ** **Virtual** : This role enables associates to… more
- Elevance Health (Miami, FL)
- …Accounts Medical Director ** is responsible for serving as the Operational Medical Director for our care management models for our National Account ... we serve. The medical director supports product strategy/design through medical management that impact health care quality, cost, and outcomes, and… more
- Centene Corporation (Tallahassee, FL)
- …the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit. + ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a...performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals… more
- Elevance Health (Miami, FL)
- …The ** Medical Director , Cardiology** is responsible for supporting the medical management staff ensuring timely and consistent medical decisions to ... **Clinical Operations Medical Director ** **Carelon MBM** **Virtual:** This role enables associates to work virtually full-time, with the exception of required… more
- Evolent (Tallahassee, FL)
- …accountability for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical Director ... Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management , you will be a key member of the...process. + On a requested basis, may function as Medical Director for selecting health plans or… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- Position Summary: The Director of Medical Management is responsible for the strategic direction, leadership, and oversight of all medical management ... accreditation requirements. This position is responsible for the day-to-day management of the Medical Management ...+ At least 3-5 years in a leadership or director -level role managing teams. + Strong knowledge of regulatory… more
- Select Medical (Oxford, FL)
- **Overview** **Critical Illness Recovery Hospital** ** Director of Case Management ** **_Clinical license as a registered nurse or respiratory therapist or ... in social work and minimum three (3) years of medical case management or similar experience._** **Previous...doing well by doing what is right. As the Director of Case Management **,** you will… more
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