Director of Utilization Management
3 weeks ago
Essential Responsibilities:
- Provides overall direction, design, development implementation and monitoring of utilization programs to meet the utilization goals while maintaining customer satisfaction.
- Analyzes root causes for spikes in utilization in Medicare Part A, B and D. Takes data driven approach when formulating utilization management solutions.
- Creates, manages and updates preferred specialist networks focused on cost-effectiveness and high quality.
- Creates, manages and updates, preferred medication/device formulary.
- Develops and implements disease management interventions to lower cost of care.
- Measures and tracks effectiveness of interventions through KPIs, scorecards and CRM system.
- Analyzes and reports significant utilization trends, patterns, and impact to appropriate departmental and medical staff committees.
- Assures compliance with Federal, State, TJC, NCQA, other regulatory agencies and internal standards and requirements.
- Hires, coaches, trains and disciplines staff to ensure smooth operations in utilization management.
- Also facilitates educational training for medical staff on issues related to utilization management.
- Minimum three years of experience in directing utilization management and discharge planning in a clinic setting,
- Strong acumen in analytics - experience with creating, tracking KPIs and measuring ROI of programs,
- Demonstrated interpersonal, negotiation, and leadership skills.
- Effective oral and written communication skills.
- Up to50% travel to medical centers across Florida
-
Aquatics Director
2 days ago
Doral, United States YMCA of South Florida Full timeThe Aquatics Director is responsible for preparing and administering the Aquatics Operations, coordinating swim lessons, and ensuring compliance to the grant-funded water-related components. In addition, the Aquatics Director will manage the Aquatics staff to include training staff and ensure that all safety and risk management procedures are...
-
Director of Finance
2 days ago
Doral, United States Mecca HR Solutions Full timeWe’re looking for a Director of Finance for a luxury boutique hotel: Responsibilities include but are not limited to: Supervise employees performing financial reporting, accounting, billing, collections, payroll, and budgeting duties. Develop internal control policies, guidelines, and procedures for activities such as budget administration, cash and credit...
-
Medical Director Surgery, Transplant Lab
7 days ago
Doral, United States University of Miami Health System Full timeThe Department of Surgery -Transplant Lab has an exciting opportunity for Associate Director of Medical Transplant Lab - Open Rank clinical faculty member.Job Functions:The associate director will work under the supervision of the interim medical director with potential opportunity to grow into Medical Director of Transplant LaboratoryProvide specialized...
-
Marketing Director
3 days ago
Doral, United States Shaw Search Partners Full timeShaw Search Partners is proud to lead the retained search for a Marketing Director with a renowned practice management firm. The firm acquires and grows exceptional practices within the medical aesthetics and plastic surgery categories across the country. Founded by 2 Harvard MBAs and based in Miami, Florida, the company specializes in high-end,...
-
Director of Risk Management
19 hours ago
Doral, United States Velox Clearing Full timeA Correspondent-Clearing broker/dealer located in the Miami, Florida metro area is seeking a Manager/Director of Risk. The successful candidate will be responsible for oversight and implementation of the clearing firms client risk program. The role will involve everything from risk policy creation to daily implementation. In addition, candidates will work...
-
Business Intelligence Manager
7 days ago
Doral, United States OneSpaWorld Full timePosition Summary Business Intelligence Manager (Insights) One Spa World is seeking a motivated, experienced, and highly skilled Business Intelligence Manager to join our team. In this role, you will lead a team of insights analysts in identifying business opportunities through analytics. This role requires natural curiosity, strategic thinking, business...
-
Director of Community Engagement
7 days ago
Doral, United States Adrienne Arsht Center for the Performing Arts of Miami-Dade County Full timeBasic Function Reporting to the Vice President, Education and Community Engagement, the Director of Community Engagement is responsible for developing and implementing a comprehensive community programs strategy for the Performing Arts Center. In addition to planning, the Director will be responsible for the day-to-day management of the Center’s Community...
-
Business Valuation Senior Manager or Director
2 weeks ago
Doral, United States McLean Intelligent Workforce Full timeBusiness Valuation Senior Manager or Director Miami, FL On-site Job Description Business Valuation Senior Manager or Directorwill lead valuations for privately/publicly held businesses, intangible assets, complex securities, and more. If you are looking for a dynamic work environment with room to grow, this is the position for you Lead valuations of private...
-
Account Director
21 hours ago
Doral, United States MediaCom Full timeEssencemediacom is an agency of GroupM, the leading global media investment company and are a part of WPP. In fact, we are responsible for one in every three ads you see globally. We are currently looking for an Account Director to join us. Role Overview The Account Director will serve as a senior member of the client service team and lead 6 markets across...
-
Grants Compliance Manager
2 days ago
Doral, United States YMCA of South Florida Full timeThe Grant Compliance Manager is a critical role responsible for ensuring compliance with all Youth Development grants within Miami-Dade County. Reporting directly to the Associate Executive Director of Grants & Program Operations, this role involves meticulous oversight of grant requirements, reporting, and adherence to regulatory frameworks. The Grant...
-
Business Manager
2 weeks ago
Doral, United States LVMH Perfumes & Cosmetics Full timeCompany Description Born/Co-founded in 2009, Maison Francis Kurkdjian is a luxury fragrance house that carries the name of one of the most celebrated perfumers of our time. Based in Paris, Maison Francis Kurkdjian is a Maison housed under LVMH Mot Hennessy - Louis Vuitton, the world's largest luxury group. The Maison is known for its creativity, know-how,...
-
Director of Quality Operations
4 days ago
Doral, United States EPM Scientific Full timeDirector of Quality Operations Location: Miami, Florida Work situation: On-site The Director of Quality Assurance and Manufacturing will be responsible for overseeing all aspects of quality assurance, quality control, and manufacturing operations within the pharmaceutical company. This critical role requires a strategic leader with a deep understanding of...
-
Account Director
1 week ago
Doral, United States Wavemaker Full timeMedia Planning & BuyingHybrid Remote , Miami,Florida Wavemaker is an agency of GroupM, the leading global media investment company and are a part of WPP. In fact, we are responsible for one in every three ads you see globally. We are currently looking for an Account Director to join us. Role Overview The Account Director will serve as a senior member of the...
-
Account Director
21 hours ago
Doral, United States Wavemaker Full timeMedia Planning & BuyingHybrid Remote , Miami,Florida Wavemaker is an agency of GroupM, the leading global media investment company and are a part of WPP. In fact, we are responsible for one in every three ads you see globally. We are currently looking for an Account Director to join us. Role Overview The Account Director will serve as a senior member of the...
-
Director of Revenue
3 weeks ago
Doral, United States Now Hiring You, LLC Full timeJob Description Job Description Position Summary The Firm is a national litigation firm with twenty-nine offices in fifteen states who are currently seeking a Director of Revenue for their Atlanta location. They are conveniently located in the Galleria, just steps from Truist Park. The Director of Revenue serves on a team who directly report to the Chief...
-
Director of Transportation
3 weeks ago
Doral, United States A B Property Services, Inc. Full timeJob Type Full-time Description Job Summary : The Director of Transportation is responsible for managing the movement of goods from vendors around the globe - focused on the flow of product to US ports and domestic transportation to our customers The Director of Transportation will also be responsible for determining cost-effective methods of transportation...
-
Campus Director, Admissions
3 weeks ago
Doral, United States West Coast University Full timeReporting directly to the Campus Executive Director, is responsible for ensuring the admissions process, from lead generation to enrollment in terms of number of students, quality of students, level of student expectations/satisfaction, and in accordance with West Coast University/American Career College policies and procedures and all applicable federal,...
-
Director of Marketing
1 week ago
Doral, United States 50 Eggs Hospitality Group Full timeDirector of Marketing - 50 Eggs Hospitality Group The Director of Marketing is an individual key contributor responsible for establishing and directing the marketing initiatives, including advertising, digital marketing, and public relations, as well as identifying areas of improvement and opportunities to increase brand awareness company-wide. The role is...
-
Director of Human Resources
2 weeks ago
Doral, United States Nuvani London Full timeNuvani London are recruitment specialists providing senior professionals to luxury hotels, resorts, restaurants & members clubs across The UK, Europe, Middle East & Indian Ocean. We are currently seeking a highly experienced and strategic Director of Human Resources to join our esteemed partner, an internationally renowned luxury hotel group based in Miami....
-
Director Hotel Operations
3 weeks ago
Doral, United States Norwegian Cruise Line Full timeBASIC PURPOSE: Assume lead role for critical functions in support of Onboard Provision Masters, Shoreside and Shipboard Auditing Department and onboard inventory depletion plans. Drive implementation and enhancement activities related to onboard operational technologies. Manage Quality Assurance/ Brand Standards program for the fleet. POSITION...