- Cardinal Health (Tallahassee, FL)
- …(ex. Blue Cross, Blue Shield, IPA, etc). Reporting to the Director of Managed Care , the Manager of Contracting is responsible for managing legal ... between payer and provider(s) to ensure optimal reimbursement including managed care contracting , enrollment, credentialing,...with strategy. **Essential Functions:** + In collaboration with the Director of Managed Care , negotiate… more
- Bristol Myers Squibb (Tampa, FL)
- …the latest government contracting and reporting requirements, and ensure Managed Care government pricing calculation implications are identified and ... for strategic and functional leadership of a team responsible for accurate and timely Managed Care Commercial and Medicare Part D rebate processing and payments,… more
- Bristol Myers Squibb (Tampa, FL)
- …the latest government contracting and reporting requirements, and ensure Managed Care government pricing calculation implications are identified and ... leadership of a team responsible for accurate and timely Managed Care Commercial and Medicare Part D...ability to think strategically about the impact of various contracting approaches and government regulations + Firm understanding of… more
- Caris Life Sciences (Tallahassee, FL)
- …policy coverage initiatives and contracting strategies within assigned regional managed care organization(s), and employer groups (employee benefit plans). ... Responsible for obtaining positive payer coverage policies, securing in-network contracting and maximizing reimbursement while minimizing access barriers for...+ Stay up to date on trends in the managed care market and develop strategy with… more
- Molina Healthcare (Miami, FL)
- …QUALIFICATIONS:** + At least 8 years of experience in Healthcare Administration, Managed Care , and/or Provider Network Management and Operations with an ... subject matter expertise for the design and implementation of value-based care programs across Medicaid, Medicare, and Marketplace populations, ensuring alignment… more
- BD (Becton, Dickinson and Company) (Stuart, FL)
- …LMS, and is responsible for the establishment, development and execution of the payor, managed care , and payer contracting medical policy initiatives in ... + Negotiates and manages, either directly or indirectly, with managed care providers to ensure the best...fee-for-service and rental reimbursement methodology as applicable to manage care contracting , various market rates and tactics… more
- Molina Healthcare (St. Petersburg, FL)
- …guidelines. + Experience in Utilization/Quality Program management + HMO/ Managed care experience **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** ... includes strategies that ensure a high quality of patient care , ensuring that patients receive the most appropriate ...(QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
- Highmark Health (Tallahassee, FL)
- …Insurance, Consulting or related area + 3 years Value-based reimbursement, through managed care contracting , provider reimbursement, consulting, population ... drive adoption and ROI realization. Critical partners include Advanced Analytics, Contracting , Market and Provider support teams, Actuary, Finance, Highmark Health… more
- Molina Healthcare (Orlando, FL)
- …+ 10+ years relevant experience, including 5+ years of clinical practice and 3+ years HMO/ Managed Care experience **OR** 5 years experience as a Molina Medical ... inpatient concurrent review, discharge planning, case management and interdisciplinary care team activities. + Ensures that authorization decisions are...Director + Demonstrated experience in Utilization/Quality Program management +… more
- J&J Family of Companies (Jacksonville, FL)
- …growth with National Retailers, Mass, Internet, Private Equity, Club, Channels, GPOs and Managed Care + Serve as primary business contact and communication ... are searching for the best talent for a Senior Director , National and Key Accounts to be located in...Care and other J&J Operating Companies; Provides Regional contracting support and direction to field; Takes responsibility for… more