- 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
- BayCare Health System (Largo, FL)
- …with referral sources and physicians. + Responsible for knowledge of Medicare and Managed Care regulations and requirements. + Timely response to referrals ... **There's home care and then there's BayCare HomeCare!** At BayCare,...network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands… more
- Elevance Health (Tampa, FL)
- …or related field and a minimum of 3 years experience in broad-based analytical, managed care payor or provider environment as well as experience in statistical ... **Cost of Care /Provider Contracting Data Analyst Senior** **Location:** This role...is granted as required by law. The **Cost of Care /Provider Contracting Data Analyst Senior** is responsible for providing… more
- Valor Health (Fort Pierce, FL)
- …the VA and works with these patients utilizing rules set forth by the VA for co- managed care . + Completes any and all clinical reminders "due" at the time of ... Primary Care Physician MD/DO Per Diem Fort Pierce, FL...Description Valor Healthcare is looking for a passionate Primary Care Physician to join our team at the Community… more
- BayCare Health System (Sarasota, FL)
- …with referral sources and physicians. + Responsible for knowledge of Medicare and Managed Care regulations and requirements. + Timely response to referrals ... **There's home care and then there's BayCare Homecare!** At BayCare,...network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands… more
- ChenMed (St. Petersburg, FL)
- …the Commission for Case Manager Certification (CCMC) or the American Association of Managed Care Nurses (CMCN) desired + This position requires possession and ... your kindness and joy? We're different than most primary care providers. We're rapidly expanding and we need great...great people to join our team. The Intensive Community Care Manager (ICCM) is a Registered Nurse (RN) who… more
- MyFlorida (Tallahassee, FL)
- …the Bureau's responsibility: Operations, Data Detection, Investigations, Overpayment Recovery, and Managed Care oversight. MPI operates with dynamic and ... 68039493 - MEDICAL/HEALTH CARE PROGRAM ANALYST Date: Dec 4, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify… more
- MyFlorida (Fort Lauderdale, FL)
- …a fast-paced, team-based work environment. This position is responsible for reviewing Medicaid managed care claim complaints and determining managed care ... programmatic reports of claims and provider reimbursement issues/complaints to determine managed care plan compliance with contract provisions. Coordinates and… more
- CVS Health (Tallahassee, FL)
- …**Preferred Qualifications** + Motivational interviewing skills + Call Center experience + Managed Care experience + 1-4 years of experience in healthcare ... with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we...with heart, each and every day. **Position Summary** The Care Management Associate (CMA) role is a full-time remote… more