• Medical Director-Medicaid (ABH FL)

    CVS Health (Tallahassee, FL)
    …Checkout this opportunity with Aetna, a CVS Health company! Aetna operates Medicaid managed care plans in multiple states: Arizona, Florida, Illinois, Kentucky, ... Organization A Plus +. + Electronic medical systems/record experience. + Managed Care experience. + Medicaid experience. **Pay Range** The typical pay range… more
    CVS Health (08/08/25)
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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 ... and other responsibilities as determined necessary to support optimal value based care in accordance with Medicare and Humana policy. The Medical Director will… more
    Humana (08/22/25)
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  • Clinical Sleep Specialist

    ZOLL Medical Corporation (Jacksonville, FL)
    …+ Experience working with VA hospitals and the VA System and or large managed care organizations (ie, Kaiser, WellStar) preferred. + Two years minimum of ... multi-task and prioritize work. + Familiarity with clinical reimbursement, and managed care policies and procedures is highly desirable. + Above average… more
    ZOLL Medical Corporation (08/16/25)
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  • Medical Biller (H)

    University of Miami (Medley, FL)
    …for patient information, insurance information, service descriptors, diagnosis codes and managed care authorization requirements, and coordinates corrections. + ... and insurance information, place of service, referrals, claim info record, and managed care authorization requirements. + Runs insurance eligibility and fixes… more
    University of Miami (08/02/25)
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  • Medical Director, Clinical Services

    Highmark Health (Tallahassee, FL)
    …year in Medical Management in a Health Insurance Plan; strong knowledge of managed care industry **LICENSES AND CERTIFICATION** **Required** + Medical Doctor or ... + Telephone Skills + General Computer Skills + Clinical Software + Managed Care **Language (Other than English)** None **Travel Required** 0% - 25% **PHYSICAL,… more
    Highmark Health (07/29/25)
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  • Deputy General Counsel, Litigation - REMOTE

    Prime Therapeutics (Tallahassee, FL)
    …work experience, including 12 years of experience as an attorney and 5 years representing managed care companies, health care clients, or clients in highly ... Anti-Kickback Statute, and False Claims Act, with a focus on PBM and managed care operations + Experience engaging with regulatory bodies (eg, CMS, OIG, state… more
    Prime Therapeutics (07/19/25)
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  • Lead Director, Project Program Management…

    CVS Health (Tallahassee, FL)
    …significance or those yielding cost savings. + 10+ years of experience in managed care , health insurance, marketing, or related industries. + Competency in ... organizational levels, including executive leadership. **Preferred Qualifications** + Experience within managed care or the health insurance industry. +… more
    CVS Health (08/28/25)
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  • Senior Analyst, Quality Management

    CVS Health (Tallahassee, FL)
    …activities on performance **Required Qualifications** * At least 5 years experience in managed care , hospital, or similar healthcare environment * Must have ... internal and external stakeholders **Preferred Qualifications** * Medicaid and/or Medicare managed care experience **Education** * Master's degree or equivalent… more
    CVS Health (08/24/25)
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  • Administrative Assistant

    University of Miami (Miami, FL)
    …and improve system processes, Ensure that new and current employees attend UChart, managed care and other training courses related to practice operations. + ... problems encountered by the staff pertaining to UMMG policies and procedures, insurance/ managed care contracts, referrals, etc. + Aid in setting up clinics for… more
    University of Miami (08/23/25)
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  • Clinical Pharmacist (Algo), Professional-Senior-…

    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
    Prime Therapeutics (08/19/25)
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