- Sprinklr (FL)
- …Learn more about our culture here: The Sprinklr Way. **Job Description** **Meet Our Managed Services Team!** Our Managed Services Team at Sprinklr drives product ... our team to reach their full potential. **Consultant Roles We Hire For:** Our Managed Services Team commonly hires for three Consultant roles: + ** Managed … more
- Molina Healthcare (Orlando, FL)
- …**X** **PE** **R** **I** **E** **N** **C** **E:** + Min. 2 years operational managed care experience (call center, appeals or claims environment). + Health ... claims processing background, including coordination of benefits, subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for appeals and denials. + Strong… more
- Molina Healthcare (Orlando, FL)
- …claims experience, OR one year of customer service/provider service experience in a managed care or healthcare environment. + Strong verbal and written ... communication skills. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal… more
- Elevance Health (Tampa, FL)
- …equivalent background. **Preferred Skills, Capabilities and Experiences** : + Understanding of managed care or Medicaid/Medicare strongly preferred. + Ability to ... obtain Florida Fingerprinting assessment, highly preferred. + Bilingual candidates, highly preferred. For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal… more
- Molina Healthcare (Orlando, FL)
- …**Required Experience** + 5-7 years of business analysis experience, + 6+ years managed care experience. + Demonstrates proficiency in a variety of concepts, ... practices, and procedures applicable to job-related subject areas. **Preferred Education** Bachelor's Degree or equivalent combination of education and experience **Preferred Experience** + 3-5 years of formal training in Project Management + Experience… more
- Molina Healthcare (FL)
- …EXPERIENCE** : * 5-7 years of Program and/or Project management experience. * Managed Care credentialing experience. * Experience working in a cross functional ... highly matrixed organization. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION** : * CPCS Certification, PMP, Six Sigma Green Belt, Six Sigma Black Belt Certification and/or comparable coursework desired. To all current Molina employees: If you are interested… more
- Centene Corporation (Tallahassee, FL)
- …degree (Pharm.D., MS) in pharmacy. 2+ years of mail order, retail, hospital or managed care pharmacy experience or 1+ years of pharmacy residency program ... experience. **Licenses/Certifications:** Current state's Pharmacist license with no restrictions. **Preferred Qualifications:** + Experience with provider engagement or provider relations + Must reside in Florida + Availability to work Monday through Friday… more
- Merck (Tallahassee, FL)
- …and models teamwork with extended members of the Virology Account Team (CLs, CTLs, Managed Care , Marketing) in the development of long-term account plans and ... customer centric solutions to improve value for both customers and patients. + Demonstrates the ability to embrace and maximize current and future technological capabilities and multi-channel opportunities to engage customers. + Demonstrates high-level… more
- Molina Healthcare (FL)
- …**X** **PE** **R** **I** **E** **N** **C** **E:** + Min. 3 years operational managed care experience (call center, appeals or claims environment). + Health ... claims processing background, including coordination of benefits, subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for appeals and denials. + Strong… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …required. Qualifications: + Minimum of two (2) years previous experience in a managed care organization's Credentialing department. + NAMSS CPCS certification is ... preferred, or a commitment to pursue certification within two years. + Knowledge of basic medical terminology. + Ability to analyze data and make appropriate decisions. + Ability to work as a team under stressful conditions. + Good verbal communication skills… more