- Prime Therapeutics (Tallahassee, FL)
- …(PharmD) or Bachelor of Science Pharmacy Degree + 1 years of pharmacy, managed care and/or pharmaceutical industry experience + Current pharmacist license in ... as a team. + Data review and interpretation skills required. **Preferred Qualifications** + Managed care experience (Health Plan or PBM) + Oncology experience +… more
- Molina Healthcare (FL)
- …with a minimum of 2 years' experience in health plan member interventions, managed care , or equivalent experience. + Demonstrated solid business writing ... QUALIFICATIONS:** + 1 year of experience in Medicare and in Medicaid managed care + Experience with data reporting, analysis, and/or interpretation + Certified… more
- BayCare Health System (Clearwater, FL)
- …services. Maintain proper documentation in Soarian or GE systems. Work closely with Managed Care and understands health insurances rule sets, manuals, and ... + Preferred - 1 year of Healthcare Business Office and /or Managed Care experience Equal Opportunity Employer Veterans/Disabled **Position** Central… more
- Molina Healthcare (St. Petersburg, FL)
- …medical facilities, healthcare vendor, commercial health insurance company, large physician practices, managed care organization, etc.) + Strong Knowledge of SQL ... utilized in medical coding/billing (UB04/1500 form) + Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk… 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
- Molina Healthcare (Tampa, FL)
- …or equivalent combination of education and experience. **Required Experience** + 3+ years managed care experience. + Min. 1 year experience completing delegation ... Care related field. **Preferred Experience** + 5 years managed care experience. + 2 years' experience completing delegation oversight assessments/audits. +… more
- Humana (Tallahassee, FL)
- …for the Medicaid line of business. + Utilizes broad understanding of pharmacy, managed care , PBM, market and regulatory insights to support the implementation ... Qualifications: + Bachelor's degree or equivalent + 3+ years of experience in managed care or other pharmacy related field + 3+ years of experience of leading… more
- Humana (Tallahassee, FL)
- …policy administration or related field;work experience may meet this need + 5 + years managed care experience + 5 + years in Medicaid program implementation or ... and clinical operations; Medicaid preferred + Comprehensive understanding of a Medicaid Managed Care architecture, tools, utilities and processes utilized to… more
- Molina Healthcare (Miami, FL)
- …integrity issues, and process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape ... reimbursement and claims payment integrity. + Strong working knowledge of managed care claims coding (Current Procedural Terminology (CPT), International… more
- The Cigna Group (Tampa, FL)
- …in lieu of a bachelor's degree.** MBA or MHA preferred. + **3+ years Managed Care contracting and negotiating experience involving complex delivery systems and ... with provider partners. + Intimate understanding and experience with hospital, managed care , and provider business models. + Team player with proven ability… more