- 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
- 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
- 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 (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
- 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
- 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 (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 (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
- 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
- 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
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