- Bristol Myers Squibb (Tampa, FL)
- …for strategic and functional leadership of a team responsible for accurate and timely Managed Care Commercial and Medicare Part D rebate processing and payments, ... as well as all aspects with evaluating implications of and reporting Managed Care data required for US and Puerto Rico government pricing calculations.… more
- Cardinal Health (Tallahassee, FL)
- …in defining, developing, and executing go-to-market strategies that drive engagement with Managed Care Organizations (MCOs), health plans, and payor networks. ... and lifecycle marketing. The ideal candidate brings expertise in the managed care landscape-paired with the ability to translate data and insights into… more
- MyFlorida (Tallahassee, FL)
- …Plan Management Operations (PMO). PMO is responsible for the primary oversight of Medicaid's managed care programs, with a focus on the Statewide Medicaid ... Managed Care (SMMC) program. The bureau's primary responsibility is ensuring that the managed care plans meet Medicaid contractual requirements, including… more
- Molina Healthcare (FL)
- …to those candidates with previous experience working with the Medicare population within a Managed Care Organization (MCO). Mileage is reimbursed as part of our ... & Supports. + 1-3 years in case management, disease management, managed care or medical or behavioral health settings. + Required License, Certification,… more
- Humana (Tallahassee, FL)
- …clinical specialists with recent inpatient experience preferred** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
- AdventHealth (Maitland, FL)
- …analyzing and evaluating financial and economic data related to healthcare costs and managed care payer rates and reimbursement. The role focuses on financial ... be able to complete extensive and complex financial and operational analyses of managed care contracts and proposals, analyze fee schedules, and determine… more
- AdventHealth (Maitland, FL)
- …Tricare) payer reimbursement language and methodologies. The Senior Compliance Analyst works with Managed Care staff in all AH Divisions, as well as payers ... customer service and maintain relationships with clients who include AH Managed Care Directors, Contract Denial Specialists, other AdventHealth departments,… more
- AdventHealth (Maitland, FL)
- …and mid-level tier payer contracts. Duties as assigned include leading strategic managed care contracting initiatives as directed by AdventHealth leadership; ... managed care contract review, interpretation and analysis, negotiation, reporting, implementation...leadership at all AdventHealth Florida markets, providers, and external managed care payers. Actively participations in outstanding… more
- AdventHealth (Altamonte Springs, FL)
- …low-level tier payer contracts. Duties as assigned include supporting strategic managed care contracting initiatives as directed by AdventHealth leadership; ... managed care contract review, interpretation and analysis, negotiation, reporting, implementation...leadership at all AdventHealth Florida regions, ancillaries, and external managed care payers. Actively participations in outstanding… more
- Molina Healthcare (FL)
- …Long Term Services & Supports. + 1-3 years in case management, disease management, managed care or medical or behavioral health settings. + Required License, ... Nursing **Preferred Experience** + 3-5 years in case management, disease management, managed care or medical or behavioral health settings. + 1 year experience… more