- AdventHealth (Maitland, FL)
- …government and non-contracted products. Provides expert guidance to Regional Directors and Managed Care staff in reference to technical system and application ... or trends. Pivots detail for distribution to assigned Contract Manager or analyst. Contributes to the development and implementation...and interim updates which may impact payers and products managed by other Managed Care … more
- AdventHealth (Maitland, FL)
- …Provides guidance and direction to PFS, Central Denials, Patient Access and Managed Care staff regarding contract terms and policies including; governmental ... the Florida division. This position assists the Sr. Contract Manager with ensuring that preferred contract language provides for...key contract data elements which are populated into the Managed Care database including addition of new… 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 (Orlando, FL)
- …QUALIFICATIONS:** + At least 6 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. + Applies understanding of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape… more
- Elevance Health (Tampa, FL)
- ** Managed Care Pharmacy Resident** **Location:** This role requires associates to be in-office **1 - 2** days per week, fostering collaboration and connectivity, ... a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care . The ** Managed Care Pharmacy...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- AdventHealth (Maitland, FL)
- …**Responsible for ensuring the providers are loaded timely and accurately with Managed Care contracted payers. Responsible for evaluating professional fee ... (PE) and works closely with practice office operations staff, Managed Care (MC) contracting, MC Credentialing and...+ Completes special projects as assigned by the reimbursement manager within the time frame requested. **The expertise and… more
- Molina Healthcare (Miami, FL)
- …years of experience in a pharmacy, Medication Therapy Management (MTM), Pharmacy Benefit Manager (PBM), and/or managed care setting, or equivalent combination ... Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care . **Essential Job… more
- Elevance Health (FL)
- **Senior Health Economist - Managed Care ** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and ... Health family of brands, offering clinical programs and primary care options for seniors. We are a team of...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Molina Healthcare (St. Petersburg, FL)
- …* At least 8 years clinical systems experience, preferably as a product owner / manager within a managed care , nursing informatics or health care ... implementation, and oversight of technology that drives core utilization management, care management, long-term services and supports (LTSS), clinical operations and… more
- MyFlorida (Tallahassee, FL)
- …of Floridians' health, health care services and costs, and is vital to managed care rate setting, health care economics, and health plan evaluation. ... 68046114 - ECONOMIST SUPERVISOR - SES / ACTUARIAL MANAGER Date: Oct 20, 2025 The State Personnel...and technical and analytical support with regards to the managed care rate setting process and methodologies… more