- Prime Therapeutics (Tallahassee, FL)
- …AWS, Google Cloud, Azure, Containers, Kubernetes, IaaS, PaaS, APIs, Microservices, Managed File Transfer, Streaming, DevOps, Spring, C#, .NET, Java, JEE, FHIR, ... HL7 + Experience working with regulatory compliance requirements (HIPAA and/or PCI) + Previous experience in PBM / health care industry + Previous experience working in an Agile/Product Delivery model + Strong experience with software development life cycle… more
- CVS Health (Miami, FL)
- …insurance, healthcare services, or client/account management. + Familiarity with managed care processes, healthcare sales, or pharmacy benefits. + Demonstrated ... experience with client-facing roles, including public sector or union accounts. + Strong presentation skills and the ability to tailor messages to diverse audiences. + Exceptional interpersonal and relationship-building skills, both internally and externally.… more
- Humana (Tallahassee, FL)
- …Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization + Proficient utilizing electronic medical record and ... documentation programs + Proficient and/or experience with medical terminology and/or ICD-10 codes + Prior member service or customer service telephone experience desired + Experience with SNF and/or Home Health + Prior experience with CGX, SRO and HCHB +… more
- SHI (Tallahassee, FL)
- …+ Develop service offerings that encompass implementation, migration, optimization, field, and managed services + Lead the development of SOWs, working closely with ... cross-functional teams to ensure alignment with client needs and business objectives + Create compelling presentations and supporting materials that articulate the value of SHIs service solutions + Stay current on industry trends, emerging technologies, and… more
- AdventHealth (Tampa, FL)
- …to management. Maintains knowledge of third-party payor reimbursement guidelines and managed care contracts. Responsible for receiving and addressing accounts within ... 72 hours of being routed to the claims edit work queue and coding review needed work queue. Qualifications **T** **he expertise and experiences you'll need to succeed:** + High school grad or equiv degree. Required + 3 years of work experience + RHIA -… more
- Molina Healthcare (FL)
- …**REQUIRED QUALIFICATIONS:** + At least 10 years' experience in Managed Care, specifically government programs and/or Medicare/Duals Health Plan Operations ... or equivalent combination of education and experience. + Strong leadership in a matrixed environment + Demonstrated adaptability and flexibility to a rapidly moving business environment. + Background analyzing technical performance and driving teams to… more
- Deloitte (Miami, FL)
- …our clients navigate the ever-changing threat landscape. Through powerful solutions and managed services that simplify complexity, we enable our clients to operate ... with resilience, grow with confidence, and proactively manage to secure success. Position Summary As a Google SecOps Consultant, you will play a critical hands-on role in delivering high-impact solutions across multiple high-visibility projects. Your SOC… more
- UKG (Ultimate Kronos Group) (Weston, FL)
- …start and end their days with our software, with billions of shifts managed annually through UKG solutions today. Yet it's our AI-powered product portfolio designed ... to support customers of all sizes, industries, and geographies that will propel us into an even brighter tomorrow! **Equal Opportunity Employer** UKG is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, disability,… more
- BayCare Health System (Sarasota, FL)
- …and benefit information. + Verifying insurance and benefits for all Medicare, Managed Care and Private Fee for Service Plans. Securing authorization for services ... provided by BayCare HomeCare from the payers. + Selecting the correct payer codes to provide accurate intake information. + Understanding medical criteria for securing all required information from the referral source. + Entering the appropriate financial… more
- Insight Global (Tampa, FL)
- …-- Service Now preferred. - Net+ or A+ certification - ServiceNow knowledge - Managed Service (MSP) Background null We are a company committed to creating diverse ... and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal employment opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment… more