- Humana (Tallahassee, FL)
- **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 ... Medical Director work assignments involve moderately complex to complex issues...work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference… more
- Elevance Health (Miami, FL)
- ** Medical Director - Florida Medicare Plans** Location: This role enables associates to work virtually full-time, with the exception of required in-person ... in Florida near our Miami or Tampa locations.** The ** Medical Director ** will support the following Florida...criteria (eg, MCG, InterQual, CMS guidelines). + Collaborate with UM nurses and case managers to review inpatient admissions,… more
- Molina Healthcare (FL)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... state, and local laws and regulatory requirements affecting the medical and clinical staff. + Marketplace UM ...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- CVS Health (Tallahassee, FL)
- …resistant illnesses through peer review and educational interventions. * Work with medical director teams focusing on inpatient care management, clinical ... as needed. * Outward facing position to interact and collaborate with medical / physical professional associates, the local provider community, state regulatory… more
- CVS Health (Tallahassee, FL)
- …do it all with heart, each and every day. **Position Summary:** Ready to take your Medical Director skills to the next level with a Fortune 6 company? Checkout ... Jersey, New York, Ohio, Oklahoma, Pennsylvania, Texas, Virginia and West Virginia. This Medical Director will be a "Work from Home" position primarily supporting… more
- Molina Healthcare (Jacksonville, FL)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... staff services. Maintains a working knowledge of applicable national , state, and local laws and regulatory requirements affecting...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- University of Miami (Miami, FL)
- …focused culture. Provide notification and documentation of potentially compensable events to Chief Medical Risk Officer, Director of Medical Claims and ... Risk Management has an exciting opportunity for a full-time Director , Risk Management to work on the UHealth campus.... Risk Management of UHT shall provide consultation to UM leadership that includes: Senior Management, Faculty and Staff,… more
- University of Miami (Miami, FL)
- …sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The University of Miami/UHealth Medical Training Lab at the Gordon Center is ... currently seeking a full time Nurse Educator - Medical Simulation and Education Lab to work in Miami,...development of patient care plans, incorporating evidenced-based research and national standards. + Consults with and serves as a… more
- Evolent (Tallahassee, FL)
- …Tasks are performed within the RN/LVN/LPN scope of practice, under Medical Director direction, using independent nursing judgement and decision-making, ... that do not meet established clinical criteria to the Medical Director . + Appropriately identifies and refers.... + Appropriately identifies and refers quality issues to UM Leadership. + Appropriately identifies potential cases for Care… more
- University of Miami (Miami, FL)
- …Lives The University of Miami is among the top research universities and academic medical centers in the nation, and one of the largest private employers in South ... students. The incumbent may lecture or conduct demonstrations and teach across UM schools. The Associate Professor, tenure earing, will partner and collaborate with… more