• Supervisor, Payor Contracting

    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 ... **_What Managed Care contributes to Cardinal Health_**...any other activity as it relates to payer interaction. Manager of Payor Contracting is responsible for reviewing, auditing… more
    Cardinal Health (06/11/25)
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  • Behavioral Health Nurse - Managed

    DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
    Position is On-Site The Behavioral Health Nurse - Managed Care is responsible for coordinating, monitoring, and delivering behavioral health services within a ... managed care environment. This role involves working...or master's degree in nursing (BSN/MSN) + Certified Case Manager (CCM) or similar certification + Fluent in Spanish… more
    DOCTORS HEALTHCARE PLANS, INC. (08/24/25)
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  • Health Plan Operations, Payment Integrity Program…

    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 (08/14/25)
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  • Care Manager , LTSS Field travel…

    Molina Healthcare (Tampa, FL)
    …Molina Healthcare of Florida Plan. The Florida Plan participates in the Statewide Medicaid Managed Care Program (SMMC) which is the program where most Florida ... Term Services & Supports. + 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **PREFERRED EXPERIENCE:** +… more
    Molina Healthcare (09/06/25)
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  • Medical Economics Manager

    AdventHealth (Maitland, FL)
    …strong organizational skills. The Medical Economics Manager will manage and mentor managed care staff for both the Florida and Multi-State Divisions of ... FL **The role you will contribute:** A Medical Economics Manager is responsible for overseeing the analysis and evaluation...financial and economic data related to healthcare costs and managed care payer rates and reimbursement. The… more
    AdventHealth (08/19/25)
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  • RN Care Manager Remote with field…

    Molina Healthcare (St. Petersburg, FL)
    …Nursing preferred. **Required Experience** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **Required ... and familiarity with claims is highly preferred. The Case Manager must be able to work in a high-volume...**Preferred Experience** 3-5 years in case management, disease management, managed care or medical or behavioral health… more
    Molina Healthcare (09/05/25)
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  • Care Manager (RN)

    Molina Healthcare (Miami, FL)
    …Nursing preferred. **Required Experience** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **Required ... in Nursing **Preferred Experience** 3-5 years in case management, disease management, managed care or medical or behavioral health settings. Preferred License,… more
    Molina Healthcare (08/27/25)
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  • Care Manager , Ltss (RN)

    Molina Healthcare (FL)
    …Long Term Services & Supports. + 1-3 years in case management, disease management, managed care or medical or behavioral health settings. + Required License, ... Degree in Nursing **Preferred Experience** + 3-5 years in case management, disease management, managed care or medical or behavioral health settings. + 1 year… more
    Molina Healthcare (08/09/25)
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  • Intensive Community Care Manager

    ChenMed (Largo, FL)
    …Commission for Case Manager Certification (CCMC) or the American Association of Managed Care Nurses (CMCN) desired + This position requires possession and ... expanding and we need great people to join our team. The Intensive Community Care Manager (ICCM) is a Registered Nurse (RN) who works with our highest complexity… more
    ChenMed (09/04/25)
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  • Field Care Manager Behavioral Health…

    Humana (Tampa, FL)
    …a part of our caring community and help us put health first** The Field Care Manager , Behavioral Health 2 assesses and evaluates member's needs and requirements ... care and wellbeing of members. The Field Care Manager , Behavioral Health 2 work assignments...multiple applications **Preferred Qualifications** + Bilingual in English/Spanish + Managed care experience (Medicaid) + LSW, LCSW… more
    Humana (09/05/25)
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