- HCA Healthcare (Bradenton, FL)
- …contracting issues. + Provides medical consultation on contracting, pricing, and analysis of managed care issues. Offers clinical support for appeals and denials ... regarding delegated utilization management and disease management operations under managed care contracts. Meets all regulatory/contractual/accreditation requirements… more
- HCA Healthcare (Bradenton, FL)
- …we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as a Procedural Operations Manager today with ... auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. + Free counseling… more
- MyFlorida (Pensacola, FL)
- …the Public Health Services Manager E - SES and the Health Medical Executive Director - SES regarding HIV/AIDS expenses and the development of spending plans. State ... of current legislation, activities trends and funding sources relative to HIV care . Ensure that all relevant HIV/AIDS, contracts, MOAs, and MOUs (responsibility of… more
- Merck (Tallahassee, FL)
- …of their current practice structure, business model, and key influencers ( Managed Care Organization/payers, employers, state policy), and their patients' ... Improvement, Health Outcomes, Hospital Sales, Interpersonal Relationships, Lead Generation, Managed Care , Market Analysis, Pharmaceutical Sales Training, Sales… more
- Merck (Tallahassee, FL)
- …of their current practice structure, business model, and key influencers ( Managed Care Organization/payers, employers, state policy), and their patients' ... Management, Customer Strategy, Health Economics, Interpersonal Relationships, Lead Generation, Managed Care , Market Analysis, Medical Affairs, Product Knowledge,… more
- Merck (Tallahassee, FL)
- …of their current practice structure, business model, and key influencers ( Managed Care Organization/payers, employers, state policy), and their patients' ... Improvement, Health Outcomes, Hospital Sales, Interpersonal Relationships, Lead Generation, Managed Care , Market Analysis, Medical Affairs, Pharmaceutical Sales… more
- J&J Family of Companies (Fort Lauderdale, FL)
- …business plans. + Experience interacting with KOLs, organized customers, and managed care organizations. + Effective communication, presentation, and ... trade-off decisions across customers and representatives. Works with Regional Sales Director when appropriate to make trade-offs within a larger geography. +… more
- Elevance Health (Tampa, FL)
- …experience and requires a minimum of 2 years clinical, utilization review, or managed care experience; or any combination of education and experience, which ... treatment is medically necessary and provides consultation to Medical Director on cases that are unclear or do not...not be receiving appropriate type, level, or quality of care , eg, if services are not in line with… more
- Erickson Living (Naples, FL)
- …over with a company 3% match + Onsite medical centers, providing wellness visits and sick care for all team members over 18 years of age + Free access to our on-site ... an impact + With guidance from the Human Resources Director or Department leader, plan and execute all established...be considered in lieu of experience. + For Continuing Care rotation, must complete regulatory online Health Stream courses… more
- Datavant (Tallahassee, FL)
- …payor guidelines. * **What you will bring to the table:** + Two (2) years managed care experience in UM/CM/CDI Department preferred + Knowledge of CMS, State ... government agencies, and those who deliver and pay for care . By joining Datavant today, you're stepping onto a...author appeal letter Identification of referrals to the medical director for review + Select appropriate preferred and contracted… more