- Elevance Health (Tampa, FL)
- ** Managed Care Pharmacy Resident** **Location:** This role requires associates to be in-office **1 - 2** days per week, fostering collaboration and connectivity, ... and a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care . The ** Managed Care Pharmacy Resident** will be responsible for various… more
- Prime Therapeutics (Tallahassee, FL)
- …area of study + 15 years of relevant work experience in PBM, pharmacy, health plan and/or managed care with a minimum of 8 years in Medicare and/or Medicaid in a ... **Job Posting Title** VP Government Programs - Medicare & Managed Medicaid (REMOTE) **Job Description** The Vice President Government...of PBM. We're reimagining pharmacy solutions to provide the care we would want for our loved ones. That… more
- CVS Health (Tallahassee, FL)
- …**Required Qualifications** - Candidate must reside in Florida (FL) - 5 years experience in managed care quality and/or 3 years in Medicaid managed care ... - National Committee for Quality Assurance (NCQA) accreditation experience - Medicaid managed care experience - Master's Degree **Education** Bachelor's Degree… more
- Humana (Tallahassee, FL)
- …in private practice or other patient care + Minimum of 1 year of managed care experience **OR** A current, valid, and unrestricted license as a Mental Health ... or other patient care + Minimum of 1 year of managed care experience **OR** A current, valid, and unrestricted nursing license to include: **Registered… more
- Centene Corporation (Tallahassee, FL)
- …infusion patients + Strong understanding of utilization management principles and healthcare managed care . + Proficient clinical assessment and critical thinking ... (eg, InterQual, Milliman Care Guidelines, NCCN). + Exposure to government-sponsored managed care programs (eg, Medicare, Medicaid). Pay Range: $55,100.00 -… more
- Molina Healthcare (St. Petersburg, FL)
- …experience in hospital acute care , inpatient review, prior authorization, managed care , or equivalent combination of relevant education and experience. ... unit (ICU) or emergency room. Preferred Experience Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of… more
- CVS Health (Tallahassee, FL)
- …mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and Aetna policies and procedures * Works ... includes navigating multiple systems and keyboarding. **Preferred Qualifications** * Previous Managed Care experience. * Psychology or Social Services… more
- Cardinal Health (Tallahassee, FL)
- …business including Medicare, Medicaid, and various commercial markets. The Advisor of Managed Care -National Accounts is responsible for regional retail (chain) ... pharmacy accounts from a managed care contracting perspective. The primary purpose of this role is to maintain our managed care relationship with current… more
- Highmark Health (Tallahassee, FL)
- …specialization + Experience in a Clinical Setting **Preferred** + Experience in UM/CM/QA/ Managed Care **LICENSES or CERTIFICATIONS** **Required** + Current State ... utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure appropriate resource utilization,… more
- CenterWell (Tallahassee, FL)
- …+ Experience with case management, discharge planning and patient education for adult acute care + Managed care experience + Home Health Care ... + **Required to work every other holiday.** The **Clinical Care Coordinator** helps to ensure optimal continuity of ...Care Coordinator** helps to ensure optimal continuity of care for patients transitioning into and out of our… more