- Cardinal Health (Tallahassee, FL)
- …when there are specific managed care operations questions including contract questions and analysis related to reimbursement . + Support sales including ... lines of business including Medicare, Medicaid, and various commercial markets. The Managed Care Market Manager is responsible for maintaining the relationship… more
- Highmark Health (Tallahassee, FL)
- …Healthcare, Healthcare Insurance, Consulting or related area + 3 years Value-based reimbursement , through managed care contracting, provider reimbursement ... This job supports the matrixed strategic design and analytical approach to reimbursement . To be successful, the incumbent will work closely with stakeholders across… more
- Insight Global (Maitland, FL)
- …responsible for analyzing and evaluating financial and economic data related to healthcare costs, managed care payer rates, and reimbursement . It focuses on ... Job Description Role overview: This role is focused on managed care within the payor space, commonly...to support decision-making. Contract Review: Interpret payor contract language and translate reimbursement terms into… more
- MyFlorida (Fort Lauderdale, FL)
- …reports of claims and provider reimbursement issues/complaints to determine managed care plan compliance with contract provisions. Coordinates ... care claim complaints and determining managed care compliance with the SMMC contract as...for compliance actions when issues are identified in the managed care plan provider reimbursement … more
- Molina Healthcare (FL)
- …experience. **Required Experience** 7 - 10 years minimum experience in Healthcare Administration, Managed Care , and/or Provider Network Mgmt & Operations with an ... & Operations, oversees development and implementation of provider network and contract strategies, identifying those specialties and geographic locations upon which… more
- Baylor Scott & White Health (Tallahassee, FL)
- …correspondence to collect inaccurate insurance payments and penalties according to BSWH Managed Care contracts. Maintains collection files on the accounts ... to resolve payment difficulties and penalties owed to BSWH in accordance with Managed Care contracts. Contacts insurance company representatives by telephone or… more
- Humana (Tallahassee, FL)
- …**Required Qualifications** + 2 or more years of experience in negotiating managed care contracts with physician specialty, hospital and/or other provider ... provides health insurance. Provider Contracting Professional 2 + Actively communicates contract terms, payment structures, reimbursement rates to providers… more
- Datavant (Tallahassee, FL)
- …specialist will be responsible for reviewing and validating DRGs specific to Medicare and Medicare Managed Care . Interest in coding IP charts in the event the ... contract ends. Must be able to work 40 hours/week...reviewing and validating DRGs specific to Medicare and Medicare Managed Care . Interest in coding IP charts… more
- CVS Health (Tallahassee, FL)
- …years' work experience in healthcare. + Minimum of 3 years' experience in Managed Care & Medicare business segment environment servicing providers with exposure ... + Coordinates the contracting process with healthcare providers to negotiate contract terms, fee schedules, reimbursement rates, and other contractual… more
- Bausch + Lomb (Orlando, FL)
- …development of Strategic Markets Division (SMD) sales and marketing initiatives, contract strategies, and pull-thru programs for large strategic accounts. By ... broad knowledge of the insurance market, US Healthcare delivery, prescription reimbursement and financial mechanisms. **Responsibilities** + Utilize a high level of… more