• Medical Director

    Molina Healthcare (Tampa, FL)
    …guidelines. + Experience in Utilization/Quality Program management + HMO/ Managed care experience **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** ... and action plan, which includes strategies that ensure a high quality of patient care , ensuring that patients receive the most appropriate care at the most… more
    Molina Healthcare (10/17/25)
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  • Center Administrator Assistant

    CenterWell (Orlando, FL)
    …Basic knowledge of Population Health Strategy + Bachelor's Degree + Medicare knowledge + Managed care experience + Bilingual in both English and Spanish + Value ... member of an interdisciplinary team + Solid understanding of medical care delivery, managed care financial arrangements and reimbursement + Bachelor's… more
    CenterWell (10/16/25)
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  • Diabetes Sales Specialist

    Abbott (Gainesville, FL)
    …meeting or exceeding sales quotas/objectives for ADC Products. Collaborate with various channels, Managed Care and Retail and Point of Care representatives. ... sales quotas/objectives for ADC Products. + Collaborating with various channels, Managed Care , Retail, and Point of Care representatives. + Establishing… more
    Abbott (09/18/25)
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  • Case Manager - UM II -100%

    Healthfirst (FL)
    …Qualifications: + Masters degree in a related discipline + Experience in managed care , case management, identifying alternative care options, ... York State + Department of Health (NYSDOH) regulations governing medical management in managed care + Relevant clinical work experience + Intermediate Outlook,… more
    Healthfirst (12/09/25)
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  • Credentialing Professional - Variable Staffing…

    CenterWell (Tallahassee, FL)
    …required. + Familiar with CAQH + Bilingual; English & Spanish + Experience in managed care or health care administration desired **Additional Information** + ... regarding own work approach/priorities, and follows direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional… more
    CenterWell (12/03/25)
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  • UM Coordinator

    Centers Plan for Healthy Living (Margate, FL)
    …proficiency + Strong multi-tasking abilities Preferred: + Experience working within a managed care environment Specific Technical Skills Preferred: + Computer ... a multidisciplinary care team to assist with the care of members enrolled in our Managed Long Term Care program and facilitate authorization requests… more
    Centers Plan for Healthy Living (10/14/25)
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  • Vaccine Customer Representative - San Diego, CA

    Merck (Tallahassee, FL)
    …of their current practice structure, business model, and key influencers ( Managed Care Organization/payers, employers, state policy), and their patients' ... Customer Strategy, Health Economics, Immunizations, Interpersonal Relationships, Lead Generation, Managed Care , Market Analysis, Medical Affairs, Product… more
    Merck (12/06/25)
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  • Actuarial Consultant with Medicaid Experience

    Deloitte (Jacksonville, FL)
    …engagements focused on Medicaid reimbursement, including actuarial rate development across managed care and fee-for-service, Medicaid policy, budget forecasting ... plan/insurance company experience + 1+ year(s) of experience with Medicaid managed care capitation rate development and/or fee-for-service rate development… more
    Deloitte (10/10/25)
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  • Clinical Account Director - Remote

    Prime Therapeutics (Tallahassee, FL)
    …is located + 3 years of relevant work experience in a retail, hospital, clinical and/or managed care setting, including at least 2 years of work experience in a ... clinical and/or managed care setting Must be eligible to work in the United States without the need for work visa or residency sponsorship **Additional… more
    Prime Therapeutics (12/07/25)
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  • Medical Director - Pharmacy Appeals

    Humana (Tallahassee, FL)
    …management, or similar activities **Preferred Qualifications:** + Knowledge of the managed care industry, Integrated Delivery Systems, health insurance, or ... staff to provide Humana members with optimal value based care in accordance with Medicare and Humana policy. All...a medical management review organization such as Medicare Advantage, managed Medicaid, or Commercial health insurance + Current and… more
    Humana (12/03/25)
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