- Bristol Myers Squibb (Tampa, FL)
- …for strategic and functional leadership of a team responsible for accurate and timely Managed Care Commercial and Medicare Part D rebate processing and payments, ... as well as all aspects with evaluating implications of and reporting Managed Care data required for US and Puerto Rico government pricing calculations.… more
- Bristol Myers Squibb (Tampa, FL)
- …for strategic and functional leadership of a team responsible for accurate and timely Managed Care Commercial and Medicare Part D rebate processing and payments, ... as well as all aspects with evaluating implications of and reporting Managed Care data required for US and Puerto Rico government pricing calculations.… more
- Cardinal Health (Tallahassee, FL)
- …with Health Insurance companies (ex. Blue Cross, Blue Shield, IPA, etc). Reporting to the Director of Managed Care , the Manager of Contracting is responsible ... negotiation with strategy. **Essential Functions:** + In collaboration with the Director of Managed Care , negotiate and manage assigned contracts, including… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- Position is On-Site The Behavioral Health Nurse - Managed Care is responsible for coordinating, monitoring, and delivering behavioral health services within a ... managed care environment. This role involves working...criteria for medical necessity for the requested level of care /patient status to the Medical Director . +… more
- Humana (Tallahassee, FL)
- …clinical specialists with recent inpatient experience preferred** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid ... a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with...size of region or line of business. The Medical Director conducts Utilization Management of the care … more
- Humana (Tallahassee, FL)
- …services such as inpatient rehabilitation **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage and Managed ... help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care ...medical management review organization, such as Medicare Advantage and managed Medicaid + Experience with national guidelines such as… more
- Humana (Tallahassee, FL)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with...size of region or line of business. The Medical Director conducts Utilization Management of the care … more
- Sevita (FL)
- …state government authorities and referral agencies such as counties, regional centers, managed care contractors, and government administrators. + Advocate on ... status, citizenship, or any other characteristic protected by law._ **Executive Director of Operations** **Starting at $150,000 | Florida-Based Opportunity** Are you… more
- CVS Health (Tallahassee, FL)
- …Checkout this opportunity with Aetna, a CVS Health company! Aetna operates Medicaid managed care plans in multiple states: Arizona, Florida, Illinois, Kentucky, ... every day. **Position Summary:** Ready to take your Medical Director skills to the next level with a Fortune...A Plus +. + Electronic medical systems/record experience. + Managed Care experience. + Medicaid experience. **Pay… more
- Humana (Tallahassee, FL)
- …management, or similar activities **Preferred Qualifications:** + Knowledge of the managed care industry, Integrated Delivery Systems, health insurance, or ... community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare...responsibilities as determined necessary to support optimal value based care in accordance with Medicare and Humana policy. The… more