- Cardinal Health (Tallahassee, FL)
- …companies (ex. Blue Cross, Blue Shield, IPA, etc). Reporting to the Director of Managed Care , the Manager of Contracting is responsible for managing ... contract retention and administrative tracking of all various managed care payors. Advances company payor strategy...In collaboration with the Director of Managed Care , negotiate and manage assigned contracts , including… more
- AdventHealth (Maitland, FL)
- …**Responsible for ensuring the providers are loaded timely and accurately with Managed Care contracted payers. Responsible for evaluating professional fee ... the Physician Enterprise (PE) and works closely with practice office operations staff, Managed Care (MC) contracting, MC Credentialing and Enrollment and billing… more
- AdventHealth (Maitland, FL)
- …department leadership within Patient Financial Services (PFS), Physician Practice leadership and Managed Care staff regarding contract interpretation and the ... building and maintenance of rates and terms into designated contract management systems for physician and ancillary contracts...to keep them informed of any concerns related to managed care reimbursement and operational contract… more
- CDM Smith (Miami, FL)
- …performed by the construction contractors. **Job Title:** Construction Representative 4 ( Contract Compliance Manager ) **Group:** CEI **Employment Type:** Regular ... Transportation and Public Works has awarded our team the contract to provide Construction Engineering and Inspection services for...Where it's a priority that the company takes good care of you and your family. Our employees are… more
- Molina Healthcare (FL)
- …QUALIFICATIONS:** + At least 7 years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health plan setting, ... integrity issues, and process gaps. + Apply understanding of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape… more
- Molina Healthcare (St. Petersburg, FL)
- …QUALIFICATIONS:** + At least 7 years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health plan setting, ... integrity issues, and process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape… more
- AdventHealth (Maitland, FL)
- …complex financial, operational, and analysis of managed care contracts , proposals, analyze fee schedules, and determine contract compliance. The Medical ... Medical Economics Manager will manage and mentor managed care staff for both the Florida...analyze data from various sources using knowledge of healthcare managed care contracts and healthcare… more
- Prime Therapeutics (Tallahassee, FL)
- …experience in clinical operations, quality, network, pharmacy or project management OR a managed care pharmacy residency. + Proven ability to plan, organize, ... every decision we make. **Job Posting Title** Clinical Account Manager - Georgia PDL - Remote in Georgia **Job...account(s). + Ensures revenue goals are met, cost of care and administrative expenses managed , and EBIDTA… more
- CVS Health (Plantation, FL)
- …residency preferred. **Education** + Bachelor's degree with or equivalent work experience in managed care , Medicaid and/or population health care programs. ... Health of Florida** (ABH-FL) is searching for a Senior Manager , Care Program Strategy who will be...these benefits and incentives. + Participation in RFP and contract implementations as an analytical leader of the Plan's… more
- The Cigna Group (Tampa, FL)
- …in lieu of a bachelor's degree.** MBA or MHA preferred. + **3+ years Managed Care contracting and negotiating experience involving complex delivery systems and ... and projects financial impact of larger or complex provider contracts and alternate contract terms. + Creates...provider partners. + Intimate understanding and experience with hospital, managed care , and provider business models. +… more