- AdventHealth (Maitland, FL)
- …adjudication. Provides guidance and direction to PFS, Central Denials, Patient Access and Managed Care staff regarding contract terms and policies including; ... for the Florida division. This position assists the Sr. Contract Manager with ensuring that preferred ...contract data elements which are populated into the Managed Care database including addition of new… more
- AdventHealth (Maitland, FL)
- …partners, vendors and leadership after identifying and quantifying the issue. Supports the Managed Care Contract Administration, AH Central Denials team, and ... non-contracted products. Provides expert guidance to Regional Directors and Managed Care staff in reference to technical...issues or trends. Pivots detail for distribution to assigned Contract Manager or analyst. Contributes to the… more
- Cardinal Health (Tallahassee, FL)
- …for all lines of business including Medicare, Medicaid, and various commercial markets. The Managed Care Market Manager is responsible for maintaining the ... within territory. + Support member pharmacies when there are specific managed care operations questions including contract questions and analysis related… more
- Elevance Health (Tampa, FL)
- …or related field and a minimum of 7 years experience in broad-based analytical, managed care payor or provider environment as well as in depth experience ... **Provider Contract Cost of Care Consult Senior...end results. + Works side by side with their manager . **Minimum Requirements:** Requires BA/BS degree in Mathematics, Statistics… more
- CVS Health (Tallahassee, FL)
- …**Required Qualifications** + 3-5 years of related experience, proven and proficient managed care network negotiating skills. + Strong verbal and written ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- CVS Health (Tallahassee, FL)
- …**Required Qualifications** + 3-5 years of related experience, proven and proficient managed care network negotiating skills. + Strong verbal and written ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- Elevance Health (Tampa, FL)
- …or related field and a minimum of 7 years experience in broad-based analytical, managed care payor or provider environment as well as in depth experience ... Provides the highest level of analytical support to the Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving… more
- AdventHealth (Maitland, FL)
- …strong organizational skills. The Medical Economics Manager will manage and mentor managed care staff for both the Florida and Multi-State Divisions of ... care contracts, proposals, analyze fee schedules, and determine contract compliance. The Medical Economics Manager must...that achieve net revenue targets developed by the Regional Managed Care Directors and Contract … more
- Elevance Health (FL)
- …programs for autism and depression, and insightful analytics to improve the delivery of care . **Behavioral Health Care Manager II - ABA** Location: ... Friday, 8:00 am to 5:00 pm** The **Behavioral Health Care Manager II** is responsible for managing...experience with autism services and treatment required. + Prior managed care experience required. **Preferred Skills, Capabilities… more
- Elevance Health (FL)
- **JR169828 Behavioral Health Care Manager II** Responsible for managing psychiatric and substance abuse or substance abuse disorder facility-based and outpatient ... professional treatment health benefits through telephonic or written review. The BH Care Manager (UM) job progression is primarily a provider-facing role… more