- Highmark Health (Tallahassee, FL)
- …Consulting or related area + 3 years Value-based reimbursement, through managed care contracting, provider reimbursement, consulting, population health delivery ... budgetary responsibility and authority. + Develop the overall conceptualization, strategy alignment, financial models, and high-level design of new reimbursement… more
- Molina Healthcare (FL)
- …Qualifications** **REQUIRED QUALIFICATIONS:** + At least 10 years' experience in Managed Care , specifically government programs and/or Medicare/Duals Health Plan ... strategies. + Leads and supports integrated duals product development and benefit strategy for markets. + Supports development of duals specific training. +… more
- Cardinal Health (Tallahassee, FL)
- …aligns negotiation with strategy . **Essential Functions:** + In collaboration with the Director of Managed Care , negotiate and manage assigned contracts, ... Blue Cross, Blue Shield, IPA, etc). Reporting to the Director of Managed Care , the...and administrative tracking of all various managed care payors. Advances company payor strategy and… more
- Grifols Shared Services North America, Inc (Gainesville, FL)
- …connect them with the customer as appropriate + Possess an understanding of the Managed Care landscape and when to utilize necessary internal resources to assist ... and functions including Territory Sales Representatives, Regional Sales Directors, Managed Markets, the Product Brand Team and other necessary stakeholders.… more
- Elevance Health (Miami, 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
- HCA Healthcare (Port St. Lucie, 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
- 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
- Humana (Tallahassee, FL)
- …a Health Plan or provider-based industry + Knowledge and experience in health care / managed care regulatory environment **Additional Information** To ensure ... work closely with established functions inside utilization management (Medical Director , clinician decision making teams, quality audits, prior authorization list… more
- University of Florida (Gainesville, FL)
- …Natural Resources and Environment is an interdisciplinary unit housed in IFAS and managed by several colleges on campus. UF/IFAS employs nearly 4,500 people, which ... Agricultural and Life Sciences, the Dean for Extension and Director of the Florida Cooperative Extension Service, the Dean...wide variety of shops and restaurants, world class medical care and facilities and low cost of living, Gainesville… more
- Hilton (Tallahassee, FL)
- …of a Revenue Management Consolidated Center \(RMCC\) that is offering owned, managed , and franchised Hilton hotels world\-class revenue management talent and tools\. ... reporting to Franchised Full Service, Lifestyle, and Luxury Assistant Director , you will work on projects such as the...will be like:** + Enact an appropriate Revenue Management strategy , including the pricing for all portfolio hotels assigned… more