- Sumitomo Pharma (Tallahassee, FL)
- …through various payers (commercial and government payers to include FFS and Managed Medicaid) and remove reimbursement barriers to treatment + Build and maintain ... strong relationships with key payers to facilitate successful contracting , access and reimbursement - including fostering strong relationships with payers and… more
- Molina Healthcare (FL)
- …Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims, Pharmacy, Lab and HEDIS ... scrubbing, scrapping, and cleaning of data. + 5+ Years of experience in Managed Care Organization executing similar techno functional role that involves writing… more
- Molina Healthcare (Miami, FL)
- …* 3 years' experience in Utilization/Quality Program Management * 2+ years HMO/ Managed Care experience * Experience demonstrating strong management and ... dependency services and assists with implementing integrated Behavioral Health care management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization… more
- Carnival Cruise Line (Miami, FL)
- …Effectively coordinate and collaborate with stakeholders to ensure ownership and contracting is deliberately/consciously managed and applied. + Measuring and ... compliance targets are met and that corporate reporting requirements are managed . + Responsible for all governance group preparation and administration through… more
- Molina Healthcare (Miami, FL)
- …experience, and at least 2 years as a medical director in managed care setting supporting utilization management/quality management initiatives, or equivalent ... of services provided to members - ensuring members receive the most appropriate care in the most effective setting. Contributes to overarching strategy to provide… more
- Centene Corporation (Tallahassee, FL)
- …Bachelor's degree in related field or equivalent experience. Two years of managed care or medical group experience, provider relations, quality improvement, ... relations to ensure delivery of the highest level of care to our members. Engage with providers to align...claims, contracting utilization management, or clinical operations. Project management experience… more
- HCA Healthcare (Sunrise, FL)
- …auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. + Free counseling ... assistance. + Referral services for child, elder and pet care , home and auto repair, event planning and more...compensation packages, presenting their profiles to the facilities and contracting them to work at the HCA and Non… more
- Centene Corporation (Tallahassee, FL)
- …billing, provider relations or contracting ) experience, preferably in a managed care or insurance environment.Pay Range: $55,100.00 - $99,000.00 per ... year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work… more
- J&J Family of Companies (Jacksonville, FL)
- …Our Shockwave Medical portfolio aims to establish a new standard of care for medical device treatment of atherosclerotic cardiovascular disease through its ... and projects. Establishes and implements cost-effective, results-based, and professionally managed programs and innovative initiatives for the organization and… more
- MyFlorida (Brooksville, FL)
- …the Office of Contracts SharePoint Website + Carrying out the preparations for contracting + Ensuring appropriate audit requirements are conveyed to the provider + ... Maintaining the files of records pertaining to the contract(s) managed + Securing a comprehensive list of health and...fees for military veterans who apply for a health care professional license within 60 months of an honorable… more