- Prime Therapeutics (Tallahassee, FL)
- …work experience, including 12 years of experience as an attorney and 5 years representing managed care companies, health care clients, or clients in highly ... member of the legal department's leadership team. **Responsibilities** + Lead and mentor a team of attorneys and support...False Claims Act, with a focus on PBM and managed care operations + Experience engaging with… more
- Prime Therapeutics (Tallahassee, FL)
- …area of study + 15 years of relevant work experience in PBM, pharmacy, health plan and/or managed care with a minimum of 8 years in Medicare and/or Medicaid in a ... interest, concern or opportunity + Act as a thought leader in national meetings where the company`s Medicare product...strategy to drive growth in government programs (Medicare and/or Managed Medicaid) + Proven track record of leadership with… more
- Prime Therapeutics (Tallahassee, FL)
- …is located + 3 years of relevant work experience in a retail, hospital, clinical and/or managed care setting, including at least 2 years of work experience in a ... in cooperation with Prime's operational teams to coordinate and lead client specific custom clinical pharmacy programs + Other...clinical and/or managed care setting Must be eligible to… more
- Devereux Advanced Behavioral Health (Orlando, FL)
- …tables for data analysis. + Ensure accurate billing and claims submission for Medicaid, Managed Care , and other third-party payors + Hiring and training staff. + ... management experience _preferred_ + Knowledge of Florida Medicaid, Florida Managed Care Plans, and third-party payer systems...others first, feel called to serve and called to lead . As a member of our team, you will… more
- Molina Healthcare (FL)
- …facilities, healthcare vendor, commercial health insurance company, large physician practices, managed care organization, etc.) + Proficiency with Microsoft ... utilized in medical coding/billing (UB04/1500 form) + Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk… more
- Molina Healthcare (Orlando, FL)
- …medical facilities, healthcare vendor, commercial health insurance company, large physician practices, managed care organization, etc.) + Strong Knowledge of SQL ... utilized in medical coding/billing (UB04/1500 form) + Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk… more
- Molina Healthcare (Tampa, FL)
- …Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims, Pharmacy, Lab and HEDIS ... for business data issues as assigned by the team lead . + Analyze data sets and trends for anomalies,...cleaning of data. + 3+ Years of experience in Managed Care Organization executing similar techno functional… more
- Molina Healthcare (Tampa, 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
- Humana (Tallahassee, FL)
- …health services research or health economics and outcomes research (HEOR) within a managed care or healthcare research organization + Experience in health equity ... a part of our caring community and help us put health first** The Lead Experience Researcher drives special projects to uncover the root cause of patient and… more
- Grifols Shared Services North America, Inc (Gainesville, FL)
- …the industry trends * Understanding of US payer market dynamics and how managed care organizations make decisions across commercial and public channels * ... teams to expand key initiatives and strategies to the managed markets customer base, which consists of payers, GPOs,...and clinical teams to integrate evidence into messaging . Lead competitive access positioning analysis to inform strategy and… more