• Manager , Medical Economics (Medicaid)…

    Molina Healthcare (Orlando, FL)
    …retrieving specified information from data sources. + Knowledge of healthcare operations ( utilization management , disease management , HEDIS quality measures, ... **JOB DESCRIPTION** **Job Summary** The Manager , Medical Economics provides support and consultation to...team through analyzing key business issues related to cost, utilization and revenue for multiple Molina Healthcare products. Analyzes… more
    Molina Healthcare (08/27/25)
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  • Clinical Manager , Home Health

    CenterWell (Tallahassee, FL)
    …of our caring community and help us put health first** The **Clinical Manager ** coordinates and oversees all direct care patient services provided by clinical ... review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and conducts… more
    CenterWell (10/02/25)
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  • PBM Pricing Strategy Analyst Manager…

    Elevance Health (Tampa, FL)
    **PBM Pricing Strategy Analyst Manager - CarelonRx (Specialty Pharmacy)** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering ... deliver member-centered, lasting pharmacy care. The **PBM Pricing Strategy Analyst Manager ** will be responsible for Pharmacy Services pricing and Administrative… more
    Elevance Health (09/13/25)
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  • Provider Engagement Account Manager

    Centene Corporation (New Port Richey, FL)
    …or medical group experience, provider relations, quality improvement, claims, contracting utilization management , or clinical operations. Project management ... align on network performance opportunities and solutions, and consultative account management and accountability for issue resolution. Drive optimal performance in… more
    Centene Corporation (08/03/25)
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  • LTSS Service Coordinator - Case Manager…

    Elevance Health (Jacksonville, FL)
    …associates, and may be involved in process improvement initiatives. + Submits utilization /authorization requests to utilization management with documentation ... integrated care plan, engaging the member's circle of support and overall management of the individuals physical health (PH)/behavioral health (BH)/LTSS needs, as… more
    Elevance Health (09/25/25)
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  • Senior Account Manager , Coronary - South…

    Abbott (Miami, FL)
    …This includes influencing stakeholders within the hospital, driving product utilization , support on contracting, relationship development, relationship management ... devices. We currently have an opportunity available for an **Senior** **Account Manager , Coronary,** **in South Florida.** This role will be responsible for ensuring… more
    Abbott (08/02/25)
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  • Manager Site I - Pinellas Street

    BayCare Health System (Clearwater, FL)
    … I** is responsible for: + In a minimally complex practice, oversees the utilization management and daily business operations of the physician practice at the ... + Responsible for patient access to services, insurance contract verification, utilization management , charge entry, collections, clinical support management… more
    BayCare Health System (09/12/25)
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  • Manager Site III - Suncoast

    BayCare Health System (St. Petersburg, FL)
    … Manager III** is responsible for: In a complex practice, oversees the utilization management and daily business operations of the physician practice at the ... + Responsible for patient access to services, insurance contract verification, utilization management , charge entry, collections, clinical support management… more
    BayCare Health System (09/30/25)
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  • Site Manager II - Suncoast Endocrinology

    BayCare Health System (St. Petersburg, FL)
    … II** **is responsible for:** + **In a minimally complex practice, oversees the utilization management and daily business operations of the physician practice at ... + **Responsible for patient access to services, insurance contract verification, utilization management , charge entry, collections, clinical support … more
    BayCare Health System (08/13/25)
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  • RN Case Manager PRN

    HCA Healthcare (Ocala, FL)
    …patient throughput while supporting a balance of optimal care and appropriate resource utilization . + Provides case management services for both inpatient and ... organization that invests in you as an RN Case Manager PRN? At HCA Florida West Marion Hospital, you...4 year Bachelor Degree preferred + Certification in Case Management or Utilization Review preferred + 1… more
    HCA Healthcare (08/09/25)
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