- 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 actively uses their medical background, experience, and judgement… more
- AON (Miami, FL)
- Aon is looking for an Associate Director , Client Advocacy! This position is Hybrid in our Miami, FL location. In this role, you will work closely with the sales team ... looking for a candidate who is excited to handle claims for our clients providing them unmatched support and...plan; consideration for long-term incentive awards at Aon's discretion; medical , dental and vision insurance, various types of leaves… more
- Caris Life Sciences (Tallahassee, FL)
- …and develop relationships to targeted National Payer key stakeholders from medical director , network management , and claims management . + Inform ... in-network contracts with National Payers. + Manage BCBS Caresourcing relationship. + With medical policy team, drive improved medical policies and adoption of… more
- Humana (Tallahassee, FL)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… 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. This ... 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
- Humana (Tallahassee, FL)
- …us put health first** The Corporate Medical Director relies on medical background and reviews 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)
- **Product Management Director ** Location: This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of one of our ... Elevance Health PulsePoint locations. The **Product Management Director ** will be responsible for leading the development, implementation, and management of… more
- Evolent Health (Tallahassee, FL)
- …including the CEO, CFO, CMO, pharmacy leadership, clinical operations/UM, medical economics/actuarial services/analytics, and vendor management . **Performance ... Management ** - maintain overall accountability for medical expense and P&L performance of designated client partners, including the facilitation of… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …Remote Position Position Purpose: Responsible for the overall management of the medical division including medical management , case management , ... benefit/payment components. + Work collaboratively with quality improvement, member services, medical care management , provider relations and the executive team… more
- USAA (Tampa, FL)
- …synthetic fraud and account takeover attempts + Closely partner with Strategies team, and Director of Fraud Model Management and Model Users on model builds and ... techniques to identify criminal networks engaging in fraud, scams, disputes/ claims and AML and deliver highly significant benefits +...and improve Member experience + In partnership with the Director of Model Management , quantify the value… more