• Behavioral Health Care Manager II

    Elevance Health (FL)
    …broad range of complex psychiatric/substance abuse and/or medical disorders. + Managed care experience required. **Preferred Skills, Capabilities, and ... **Behavioral Health Care Manager II - Autism** **Location:** Virtual: This...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
    Elevance Health (10/04/25)
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  • VP, Ltss - Health Care Operations (Remote)

    Molina Healthcare (Orlando, FL)
    …Nurse (APRN), etc.). + Experience leading a line of business or product line in managed health care . To all current Molina employees: If you are interested in ... Contributes to overarching strategy to provide quality and cost-effective member care . **ESSENTIAL JOB DUTIES:** + Supports executive strategy development, vision… more
    Molina Healthcare (09/25/25)
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  • Manager of Physician Contract Administration

    AdventHealth (Maitland, FL)
    …leadership within Patient Financial Services (PFS), Physician Practice leadership and Managed Care staff regarding contract interpretation and the implementation ... accurately maintained for documentation and historical purposes. Takes a lead role in managing projects such as the development...to keep them informed of any concerns related to managed care reimbursement and operational contract issues.… more
    AdventHealth (08/26/25)
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  • Field Reimbursement Senior Manager - South East

    Amgen (Jacksonville, FL)
    …2 years of public or private third-party access arena or pharmaceutical industry in sales, managed care , or clinical support OR Master's degree AND 4 years of ... will participate in strategic meetings at various levels and lead their team to success. + Lead ...private third-party access arena or pharmaceutical industry in sales, managed care , or clinical support OR Bachelor's… more
    Amgen (10/05/25)
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  • VP Population Health

    AdventHealth (Maitland, FL)
    …various CMS programs and bundled payments. . Fosters effective collaboration between the PHSO, Managed Care , CIN providers, AH medical groups, Acute Care ... strategy, process, and implementation of key operational roll-outs that lead to new care programs, evidence based... care , risk-based payment models, commercial bundles and managed care contracting. . Ability to build… more
    AdventHealth (08/07/25)
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  • Lead Analyst, Payment Integrity - REMOTE

    Molina Healthcare (Orlando, FL)
    …integrity issues, and process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape ... **Job Description** **Job Summary** Provides lead level support as a highly capable business...as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health plan… more
    Molina Healthcare (09/28/25)
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  • Medical Director - Gulf South

    Humana (Tallahassee, FL)
    …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
    Humana (10/03/25)
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  • Medical Director-Payment Integrity

    Humana (Tallahassee, FL)
    …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized at the Inpatient… more
    Humana (09/26/25)
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  • Medical Director - Mid West Region

    Humana (Tallahassee, FL)
    …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... experience, and judgement to make determinations whether requested services, level of care , and/or site of service should be authorized. All work occurs within… more
    Humana (09/16/25)
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  • Medical Director - Northeast Region

    Humana (Tallahassee, FL)
    …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... + MD or DO degree + 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an… more
    Humana (07/25/25)
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