- Florida Health Care Plans, Inc. (Daytona Beach, FL)
- …Social Work (MSW). * Minimum 3 years previous experience working in managed care /healthcare settings, preferably with diverse patient populations. * Experience ... services to assist members with emotional, social and financial factors that affect care . In order to fully engage with members and their families, travel to… more
- AdventHealth (Maitland, FL)
- …leadership within Patient Financial Services (PFS), Physician Practice leadership and Managed Care staff regarding contract interpretation and the implementation ... leaders to keep them informed of any concerns related to managed care reimbursement and operational contract issues. Ensures key stakeholders are aware… more
- MyFlorida (Tallahassee, FL)
- …of Floridians' health, health care services and costs, and is vital to managed care rate setting, health care economics, and health plan evaluation. ... to Agency staff and contracted entities on work related to state Medicaid managed care plans, capitation rates, financial analysis/projections. * Assist with the… more
- AdventHealth (Altamonte Springs, FL)
- …is responsible for educating, informing and advising members of the Utilization Management, Care Management, Managed Care and Revenue Cycle departments and ... Collaborates with Chief Medical Officers and acts as a liaison between contracted Managed Care /Commercial payors related to managed care denials, Care… more
- BayCare Health System (Tampa, FL)
- …in Florida. Responsibilities + Responsible for initiating and maintaining credentialing, managed care provider enrollment and hospital privileges for BayCare ... requirements and will assist providers with renewals. + Enrolls and maintains managed care enrollment by providing updates to the health/payor plans and will… more
- AbbVie (Pensacola, FL)
- …Commercial pharmaceutical industry experiences such as physician/account-based selling, training, managed health care or marketing preferred. English language ... key therapeutic areas - immunology, oncology, neuroscience, and eye care - and products and services in our Allergan...of your position is to satisfy all applicable health care industry representative (HCIR) credentialing requirements to gain and… more
- Caris Life Sciences (Tallahassee, FL)
- …medical policy coverage initiatives and contracting strategies within assigned regional managed care organization(s), and employer groups (employee benefit ... payers to contract terms. + Stay up to date on trends in the managed care market and develop strategy with senior management to address the changes and maintain… more
- Humana (Tallahassee, FL)
- …services such as inpatient rehabilitation **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage and Managed ... The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments… more
- AdventHealth (Maitland, FL)
- …various CMS programs and bundled payments. . Fosters effective collaboration between the PHSO, Managed Care , CIN providers, AH medical groups, Acute Care ... health value-based care , risk-based payment models, commercial bundles and managed care contracting. . Ability to build and maintain optimal peer and… more
- CVS Health (Tallahassee, FL)
- …training in a medical specialty). * Three 3+ years of experience in the managed care industry. * Experience in leading interdisciplinary teams. * Solid ... understanding of and concurrence with evidence-based medicine (EBM) and managed care principles. * Ability to travel on as needed basis; planned and scheduled in… more