- BD (Becton, Dickinson and Company) (Stuart, FL)
- …for the establishment, development and execution of the payor, managed care , and payer contracting medical policy initiatives in collaboration ... + Negotiates and manages, either directly or indirectly, with managed care providers to ensure the best...fee-for-service and rental reimbursement methodology as applicable to manage care contracting , various market rates and tactics… more
- Evolent (Tallahassee, FL)
- …and proficiency + Personally initiate and foster executive level relationships at managed care organizations or health systems and large provider groups ... cycles requiring diverse stakeholder management + Knowledge of the managed care and provider markets (both payers...for healthcare and subscribed to the vision of value-based care + Strong familiarity with risk-based contracting … more
- Cardinal Health (Tallahassee, FL)
- …place between payer and provider(s) to ensure optimal reimbursement including managed care contracting , enrollment, credentialing, and any other activity ... as it relates to payer interaction. Manager of Payor Contracting is...Blue Shield, IPA, etc). Reporting to the Director of Managed Care , the Manager of Contracting… more
- AdventHealth (Maitland, FL)
- …mid-level tier payer contracts. Duties as assigned include leading strategic managed care contracting initiatives as directed by AdventHealth leadership; ... overall contracting process by coordinating with other Managed Care teams and outside business units...Care department. + Facilitates contract negotiations and other managed care projects in all payer… more
- Caris Life Sciences (Tallahassee, FL)
- …policy coverage initiatives and contracting strategies within assigned regional managed care organization(s), and employer groups (employee benefit plans). ... Responsible for obtaining positive payer coverage policies, securing in-network contracting and...+ Stay up to date on trends in the managed care market and develop strategy with… more
- AdventHealth (Maitland, FL)
- …Provides guidance and direction to PFS, Central Denials, Patient Access and Managed Care staff regarding contract terms and policies including; governmental ... strong working relationship with AdventHealth Florida and Multi-state Division leadership, Managed Care Reimbursement team, Regional Revenue Cycle leadership,… more
- AdventHealth (Altamonte Springs, FL)
- …process improvement and reporting + Reviews denials data and trends and works with Managed Care contracting team and patient financial services to identify ... educating, informing and advising members of the Utilization Management, Care Management, Managed Care and...increase clean claims rate + Performs peer-to-peer discussions with payer Medical Directors and/or discusses cases with payer… more
- HCA Healthcare (Port St. Lucie, FL)
- …+ Provides medical consultation on contracting , pricing, and analysis of managed care issues. Offers clinical support for appeals and denials process, ... regarding delegated utilization management and disease management operations under managed care contracts. Meets all regulatory/contractual/accreditation requirements… more
- Highmark Health (Tallahassee, FL)
- …Insurance, Consulting or related area + 3 years Value-based reimbursement, through managed care contracting , provider reimbursement, consulting, population ... both the return on investment (ROI) and other decisions on the payer partnership constructs. These new approaches require new operational capabilities, and this… more
- Grifols Shared Services North America, Inc (Gainesville, FL)
- …connect them with the customer as appropriate + Possess an understanding of the Managed Care landscape and when to utilize necessary internal resources to assist ... and functions including Territory Sales Representatives, Regional Sales Directors, Managed Markets, the Product Brand Team and other necessary stakeholders.… more
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