Current jobs related to Medicare Medical Director Clinical Programs - Doral - Elevance Health
-
Clinical Research Director
4 days ago
Doral, Florida, United States Vitaly Clinical Research Center Full timePrincipal Investigator Opportunity at Vitaly Clinical Research CenterVitaly Clinical Research Center is a leading facility dedicated to conducting cutting-edge clinical trials sponsored by top pharmaceutical companies. We are seeking an experienced Principal Investigator (MD/DO) with a specialization in Dermatology to oversee research protocols and ensure...
-
Clinical Operations Manager
1 week ago
Doral, Florida, United States Leon Medical Centers Full timeCare Management SupervisorThe Care Management Supervisor plays a pivotal role in supporting the Health Services Department in achieving clinical quality and service objectives. This position is responsible for facilitating the Case Management processes, directing and coordinating activities associated with the day-to-day operations of the Case Management...
-
Clinical Operations Director
4 days ago
Doral, Florida, United States University of Miami Full timeExecutive Director, Clinical OperationsAt the University of Miami, we are seeking a highly skilled and experienced Executive Director, Clinical Operations to join our team. This is a full-time position with a hire date of December.About the RoleThe Executive Director, Clinical Operations will be responsible for the direction and management of our clinical...
-
Medication Management Specialist
4 weeks ago
Doral, Florida, United States Leon Medical Centers Full timeSUMMARYThe Medication Management Specialist plays a crucial role in ensuring that Leon Medical Centers' members receive all necessary prescription medications in a safe and cost-effective manner, while adhering to all applicable federal and state regulations. Key responsibilities encompass formulary oversight (including the assessment of prior authorization...
-
Medical Director of Electrophysiology
1 day ago
Doral, Florida, United States FLORIDA NATUROPATHIC PHYSICIANS ASSOCIATION Full timeJob Title: Medical Director of ElectrophysiologyWe are seeking a highly skilled and experienced Pediatric Electrophysiologist to serve as the Medical Director of Electrophysiology at Nicklaus Children's Hospital Heart Institute.Job Summary:The Medical Director of Electrophysiology will be responsible for leading and overseeing the Electrophysiology Program,...
-
Medical Director of Electrophysiology
2 days ago
Doral, Florida, United States Nicklaus Children's Health System Full timeJob Title: Medical Director of ElectrophysiologyWe are seeking a highly skilled and experienced Pediatric Electrophysiologist to serve as the Medical Director of Electrophysiology at Nicklaus Children's Hospital Heart Institute.About the RoleThe successful candidate will lead and oversee the electrophysiology program, providing expert consultation and...
-
Senior Clinical Program Manager
4 weeks ago
Doral, Florida, United States University of Miami Full timePosition Overview:The University of Miami is seeking a Senior Clinical Program Manager to join our esteemed Bascom Palmer Eye Institute team. This role is pivotal in the development, organization, and assessment of various health promotion and educational initiatives aimed at enhancing patient care within the designated unit.Key Responsibilities:1. Lead the...
-
Clinical Education Program Coordinator
2 weeks ago
Doral, Florida, United States Florida International University Full timeJob SummaryThe Herbert Wertheim College of Medicine at Florida International University is seeking a highly organized and detail-oriented Clinical Education Program Coordinator to join their team. This role will be responsible for managing the onboarding, assignment, and training of learners to the Neighborhood Help (NHELP) program, including medical,...
-
Clinical Associate Professor in Cardiology
4 weeks ago
Doral, Florida, United States University of Miami Full timePosition Overview:The University of Miami is seeking a qualified individual for the role of Clinical Associate Professor in Cardiology. This position involves significant responsibilities in the development and management of the Adult Heart Transplant and Ventricular Assist Device (VAD) program.Key Responsibilities:Collaborate with the Surgical Director of...
-
Clinical Assistant Professor of Medicine
2 weeks ago
Doral, Florida, United States University of Miami Full timeJob SummaryWe are seeking a highly skilled and experienced Clinical Assistant Professor of Medicine to join our team at the University of Miami. As a key member of our faculty, you will play a vital role in the development and growth of our Adult Heart Transplant and Ventricular Assist Device (VAD) program.Key ResponsibilitiesParticipate in the research,...
-
Educational Program Coordinator
2 weeks ago
Doral, Florida, United States Florida International University Full timeJob SummaryThe Herbert Wertheim College of Medicine at Florida International University is seeking a highly organized and detail-oriented Educational Program Coordinator to join their team. This role will be responsible for managing the onboarding and training of learners in the Neighborhood Help (NHELP) program, including medical, nursing, social work, and...
-
Clinical Liaison RN
6 days ago
Doral, United States AccentCare Full timeOverview Find Your Passion and Purpose as a Clinical Liaison RN Reimagine Your Career in Hospice As a medical professional, you know that what you do impacts you as much as your patients and their families. At AccentCare, we are united in our relentless drive to reimagine care because we want to provide the service we would seek for our own families. We...
-
Program Specialist- Part-Time
1 week ago
Doral, United States Aspen Medical International Full timeProgram Specialist- Part Time About Big Brothers Big Sisters (BBBS) of Miami BBBS of Miami is an award-winning, innovative organization that ignites the potential within each child and advocates for them to explore the endless possibilities of what they can accomplish. Our Vision All youth achieve their full potential. Our Mission Create and support...
-
Senior Clinical Nurse Specialist
4 days ago
Doral, Florida, United States Integrated Resources Full timeIntegrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy...
-
Clinical Radiation Physicist
4 weeks ago
Doral, Florida, United States University of Miami Full timeCurrent Employees:If you are a current Staff, Faculty or Temporary employee at the University of Miami, please log in to Workday to utilize the internal application process.To learn how to apply for a faculty or staff position using the Career worklet, please review this tip sheet.Transforming LivesThe University of Miami stands as a premier research...
-
Manager Clinical Pharmacy
1 month ago
Doral, United States Bileddo Associates Full timeManager Clinical Pharmacy Miami, FL Our client is a 415+ bed, full-service, acute hospital providing 24-hour comprehensive care in the community including trauma, burn, surgical, women’s and children’s services, behavioral health and diagnostic services, along with two full service free-standing ER facilities. Job Description: As Pharmacy Clinical...
-
Program Specialist- Part-Time
1 week ago
Doral, Florida, United States Aspen Medical International Full time{"title": "Program Specialist", "subtitle": "Join Our Team", "content": "About the Role:We are seeking a highly motivated and organized Program Specialist to join our team at Aspen Medical International. As a Program Specialist, you will play a crucial role in executing our mission by facilitating mentoring relationships, managing volunteer recruitment, and...
-
Clinical Liaison RN
4 days ago
Doral, Florida, United States AccentCare Full timeUnlock Your Potential as a Clinical Liaison RNAt AccentCare, we're reimagining care to provide world-class patient experiences. As a Clinical Liaison RN, you'll play a vital role in shaping the future of healthcare. Join our team of compassionate professionals who are dedicated to delivering exceptional care and making a meaningful difference in the lives of...
-
Senior Director of Operations
2 weeks ago
Doral, Florida, United States Mia Aesthetics Full timeAbout the RoleMia Aesthetics is seeking an experienced and dynamic Senior Director of Operations to lead and enhance the operational capabilities of our organization.Key ResponsibilitiesProvides leadership and direction to the Directors of Clinic Operations, fostering a culture of high performance and continuous improvement.Oversees day-to-day operations,...
-
Principal Analyst, Medical Cost Strategies
3 weeks ago
Doral, Florida, United States ChenMed Full timeAbout Us:At ChenMed, we are committed to transforming healthcare for seniors and enhancing the well-being of the communities we serve. Our unique, family-owned and physician-led approach enables us to deliver exceptional care while fostering a supportive environment for our team members.Position Overview:The Senior Health Economics Analyst plays a pivotal...
Medicare Medical Director Clinical Programs
3 months ago
Description
Wellpoint, formerly Amerigroup, is a proud member of Elevance Health's family of brands, offering Medicaid and Medicare plans in several states. We also provide administrative services to Medicaid plans in partnership with blue cross blue shield plans.
This is an individual contributor role. This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health office locations Work schedule: Monday - Friday, standard business hours.
The Medical Director Clinical Programs is responsible for designing and implementing clinical programs with specific medical condition focus for all lines of business enterprise wide. Analyzes and interprets data in collaboration with data and analytics to identify opportunities. Partners with LOB (line of business) and Market leaders to ensure clinical solutions align with membership health priorities. Collaborates with payment innovation on clinical programs that support providers in value-based payment arrangements. Serves as a subject matter expert/collaborator with LOB, leaders, and other clinical initiatives including cost of care. This role will work on Cost of Care, trend management, value-based care support for STARS/HEDIS and correct coding initiatives with providers as well as strategic growth and innovation initiatives.
How you will make an impact:
* Designs and develops national level interventions leveraging existing tools that will drive performance in value-based care in support of the innovation and execution of corporate clinical interventions.
* Provides clinical expertise, captures and shares best practices across regions to provider partners as well as the company's medical directors by way of studying designs, analytics and reporting for clinical quality that drives improved healthcare outcomes.
* Provides an end-to-end clinical solution by taking a problem from initiation to execution with reporting and analytics as an outcome.
* Accountable for achieving performance results in value-based care by engaging, influencing and supporting physicians.
* Engages with providers in joint operating committees and builds relationships with clinical leadership of provider collaboration groups.
* Promotes clinical best practice sharing across all lines of business to improve results and drive efficiency and effectiveness.
* Works to develop and deliver high impact interventions, supporting content development and practice transformation embedded capabilities to significantly improve provider performance that drive cost of care and improve HEDIS/Stars where applicable.
Minimum Requirements:
* Requires MD or DO and Board certification approved by one of the following certifying boards is required, where applicable to duties being performed, American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA).
* Must possess an active unrestricted medical license to practice medicine or a health profession.
* Unless expressly allowed by state or federal law, or regulation, must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military base, vessel or any embassy located in or outside of the US.
* Minimum of 10 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities and Experiences:
* Consulting experience and/or MBA.
* Managed care experience improving cost of care trend.
* Experience working with provider groups including practice managers, population health and quality directors on improving STARS/HEDIS or Risk Adjustment performance.
* Six Sigma or formal process improvement experience preferred.
* Analytical experience in creating study designs, ROIs and statistical techniques preferred.
* Advanced knowledge in health care systems and health policy, quality measures, performance measurement, and quality improvement, and the clinical understanding for clinical quality programs strongly preferred.
* Travel up to 25% may be required depending on market needs.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.comfor assistance.
#J-18808-Ljbffr