- Takeda Pharmaceuticals (FL)
- …national level. + Use available tools and resources to monitor and evaluate industry/ managed care trends and communicate relevant information to those who are ... selling opportunities and adaptability to changing market conditions + Understanding of managed care landscape and how it influences/impacts business + Strong… more
- AdventHealth (Maitland, FL)
- …appropriate follow up for account completion. Stays current with payor guidelines, managed care changes to authorization practices, all relevant payor portals ... initial communication with service partners inclusive of medical group, managed care , ancillary and support departments and...according to policy. Is readily available to staff and Lead in person or by phone to answer questions… more
- Molina Healthcare (Miami, FL)
- …SKILLS & ABILITIES** : * 7+ years experience in Healthcare Administration, Managed Care , Provider Contracting and/or Provider Services, including 2+ years ... with other operational departments and functional business unit stakeholders to lead or support various Provider Contracting functions. This role primarily leads… more
- AdventHealth (Tampa, FL)
- …Customer Service or case management. The Nurse Auditor will work closely with the FH/ Managed Care department anytime there are audits requested by an insurance ... Ocala and Wesley Chapel. **The value you'll bring to the team:** Assist FH/ Managed Care Department when outside agencies conduct audits involving hospital… more
- Abbott (Gainesville, FL)
- …opportunity in the Abbott Diabetes Care Division. We are helping people with Diabetes lead healthier, happier lives. As a global leader in diabetes care , ... Abbott is a global healthcare leader that helps people live more fully at...sales quotas/objectives for ADC Products. Collaborate with various channels, Managed Care and Retail and Point of… more
- BD (Becton, Dickinson and Company) (Stuart, FL)
- …and is responsible for the establishment, development and execution of the payor, managed care , and payer contracting medical policy initiatives in collaboration ... have direct supervision of the contract administration staff and lead all aspects of vendor management. **Primary duties and...+ Negotiates and manages, either directly or indirectly, with managed care providers to ensure the best… more
- HCA Healthcare (Loxahatchee, FL)
- …contracting issues. + Provides medical consultation on contracting, pricing, and analysis of managed care issues. Offers clinical support for appeals and denials ... regarding delegated utilization management and disease management operations under managed care contracts. Meets all regulatory/contractual/accreditation requirements… more
- CVS Health (FL)
- …open to qualified candidates within the United States. **Required Qualifications** 10+ years of Managed Care experience in health plan and/or PBM roles 10+ years ... CMS audit experience HPMS experience **Preferred Qualifications** 15+ years of Managed Care experience in health plan and/or PBM roles 15+ years Medicare… more
- Humana (Tallahassee, FL)
- …policy administration or related field;work experience may meet this need + 5 + years managed care experience + 5 + years in Medicaid program implementation or ... and clinical operations; Medicaid preferred + Comprehensive understanding of a Medicaid Managed Care architecture, tools, utilities and processes utilized to… more
- Elevance Health (Tampa, FL)
- …acute care setting. + Minimum 2 years "telephonic" Case Management experience with a Managed Care Company. + Managed Care experience. For candidates ... The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more