- Humana (Tallahassee, FL)
- …support across a broad range of actuarial, managerial, and business needs for Medicaid -specific product lines. The Lead Actuary will serve as a project manager ... review and documentation. The Lead Actuary will be responsible for Medicaid -specific functions such as capitation rate review, drafting rate advocacy communications,… more
- Molina Healthcare (FL)
- **JOB DESCRIPTION** **Job Summary** The Manager , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina...- 5 years supervisory experience + Demonstrated understanding of Medicaid and Medicare programs or other healthcare plans +… more
- HCA Healthcare (Gainesville, FL)
- …Act (CLIA) as well as compliance with standards of the Centers for Medicare & Medicaid Services (CMS). The Manager supervises all employees in the lab and is ... each individual is recognized. Submit your application for our Manager Cell Therapy Lab opening with HCA Florida North...benefits may vary by location._** We are seeking a(an) Manager Cell Therapy Lab for our team to ensure… more
- Humana (Tallahassee, FL)
- …part of our caring community and help us put health first** The Manager , Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. ... The Manager , Fraud and Waste works within specific guidelines and...experiences **Preferred Qualifications** + Proven knowledge in Medicare and Medicaid regulations + Certifications (BA, MBA, JD, MSN, Clinical… more
- CenterWell (Tallahassee, FL)
- …a part of our caring community and help us put health first** The Medicaid Drug Strategy Pharmacist Lead requires a broad understanding of pharmacy, managed care, ... drug strategies to mitigate cost trend and improve health outcomes. The Medicaid Drug Strategy Pharmacist Lead work assignments involve moderately complex to complex… more
- Elevance Health (Tampa, FL)
- **Business Information Analyst Senior - Medicaid Encounters Data** The **Business Information Analyst Senior** is responsible for analyzing and validating healthcare ... encounter data submissions to CMS (Centers for Medicare & Medicaid Services). This role involves ensuring the accuracy and...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Molina Healthcare (Jacksonville, FL)
- …monitor, and troubleshoot Hadoop-based infrastructure using tools such as Cloudera Manager , Ambari, and Zookeeper. * Enforce data quality, security, and compliance ... in deploying and monitoring big data infrastructure with Ambari, Cloudera Manager , and Zookeeper. * Solid understanding of data warehousing, data validation,… more
- Humana (Tampa, FL)
- …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 to achieve ... the care and wellbeing of members. The Field Care Manager , Behavioral Health 2 work assignments are varied and...50-75%, about 3 days weekly travel to meet with Medicaid members in hospitals and acute settings. The hours… more
- Humana (Hallandale Beach, FL)
- …for a period up to 11 weeks. The Telephonic Behavioral Health Care Manager Intern will utilize Humana's Medicaid training and engage formerly acquired ... first? During the period of this unpaid internship, you will work with the Medicaid Clinical Services team to ensure interaction between the company and members are… more
- Prime Therapeutics (Tallahassee, FL)
- …passion and drives every decision we make. **Job Posting Title** Manager Rebate Pharmacy Operations **Job Description Summary** This position provides administrative ... teamwork across all internal departments, as well as with Medicaid Clients, and an in-depth understanding of all rebate...state laws and standards of practice which govern the Medicaid Drug Rebate Program. + Ensures compliance with each… more