- 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 (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
- Elevance Health (Miami, 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
- Humana (Tallahassee, FL)
- …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- University of Miami (Miami, FL)
- …of Miami/UHealth has an exciting opportunity for an Executive Director , Risk Management . The Executive Director , UHealth Medical Risk Management ... and is responsible for operational direction and oversight of medical risk management efforts in accordance with...meetings as appropriate. + Coordinate with the UHealth Executive Director for Claims Prevention and Litigation Management … 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
- Select Medical (Miami, FL)
- **Overview** **Hospital Name: West Gables Rehabilitation Hospital** **Partnership with Select Medical ** **Position:** Director of Case Management **Location: ... management criteria, and implementation of safe and appropriate discharge plans. The Director of Case management is also responsible for maintaining a patient… more
- Select Medical (Gainesville, FL)
- **Overview** **Select Specialty Hospital** **Critical Illness Recovery Hospital (LTACH)** ** Director of Case Management ** **$10,000 Sign On Bonus** **Full Time: ... 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
- Select Medical (Orlando, FL)
- …Calendar + Receiving and reviewing quarterly quality improvement reports. + Assisting the Medical Director and Quality Program Director with development and ... **Overview** **Critical Illness Recovery Hospital** ** Director of Quality Management ** At Select...** At Select Specialty/Regency Hospitals, a division of Select Medical , we care for chronically and critically ill or… more
- Humana (Tallahassee, FL)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The … more