- 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
- Molina Healthcare (Miami, FL)
- …SKILLS & ABILITIES** : * 7+ years experience in Healthcare Administration, Managed Care , Provider Contracting and/or Provider Services, including ... Georgia _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with… 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
- Ascendis Pharma (FL)
- …+ Serves as scientific resource at key medical, scientific, and other managed care -related conferences as assigned Contributes to Ascendis Pharma's Medical ... workplace for employees to grow and develop their skills. The National Director , Field HEOR serves as a strategic scientific liaison responsible for developing… 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 (St. Petersburg, 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
- Evolent (Tallahassee, FL)
- …professional experience in claims-based healthcare analytics with a payer, provider, vendor, managed care , or related healthcare consulting entity + Extensive ... people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care … more
- HCA Healthcare (Port St. Lucie, FL)
- …+ Provides medical consultation on contracting , pricing, and analysis of managed care issues. Offers clinical support for appeals and denials process, ... regarding delegated utilization management and disease management operations under managed care contracts. Meets all regulatory/contractual/accreditation requirements… more
- Prime Therapeutics (Tallahassee, FL)
- …including pharmaceutical manufacturers, with specific emphasis on Medicare Part D and Managed Medicaid. The Sr Director , Pharm Trade Relations leads a ... Sr Dir Pharmacy Trade Relations - Remote **Job Description** The Sr Director , Pharmaceutical Trade Relations is responsible for managing Prime's Trade Relations… more