- CVS Health (Tallahassee, FL)
- …projects based on resource requirements. **Required Qualifications** Strong knowledge of Medicaid to include experience with the Member Call Centers Experience with ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our… more
- Molina Healthcare (St. Petersburg, 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, ... should be knowledgeable of and have experience with South Carolina Medicaid **Job Summary** Provides subject matter expertise and responsibility for oversight,… more
- Molina Healthcare (Miami, FL)
- …goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay Edits & ... Guidelines, MCG, InterQual or other medically appropriate clinical guidelines, Medicaid , Medicare, CHIP and Marketplace, applicable State regulatory requirements,… more
- Molina Healthcare (FL)
- **Job Description** **Job Summary** The Health Plan Operations, Payment Integrity Program Manager is an individual contributor role designed for a highly capable ... 7 years of experience as a Business Analyst or Program Manager in a Managed Care Organization...experience. + At least 3 years of Experience with Medicaid and/or Medicare. + Proven experience owning operational projects… 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
- MyFlorida (Clearwater, FL)
- …policy and planning entity. The Agency is responsible for administering the Florida Medicaid program , the licensure and regulation of nearly 50,000 health care ... and high-quality health care system in the nation. The Medicaid program provides low-income families and individuals...HIV planning councils as assigned by the Field Office Manager (FOM) or Program Administrator (PA). Performs… more
- Devereux Advanced Behavioral Health (Viera, FL)
- …make a positive impact on the lives of children and Families?** **Then being a Program Manager at Devereux is for YOU! You belong here.** Devereux Advanced ... Located in **Viera, FL** ,. This position is responsible for oversight of the program and staff, certifying proper service delivery to all clients in a safe and… more
- Prime Therapeutics (Tallahassee, FL)
- …compliance with federal laws, state laws and standards of practice which govern the Medicaid Drug Rebate Program . + Ensures compliance with each State ... and drives every decision we make. **Job Posting Title** Manager Rebate Pharmacy Operations **Job Description Summary** This position...and regulations as they pertain to rebate processing and Medicaid Drug Rebate Program . + Ability to… more
- Molina Healthcare (Tampa, FL)
- …of external vendors. + Focuses on process improvement, organizational change management, program management and other processes relative to the business. + Serves as ... years supervisory/management experience in a managed healthcare environment. + Medicaid /Medicare Population experience with increasing responsibility. + 3+ years of… more
- Humana (Tallahassee, FL)
- …practices, and design clinical solutions for members who have Medicare and Medicaid . The Lead Product Manager partners across various multi-disciplinary teams ... members - members that qualify for both Medicare and Medicaid . The Lead Product Manager sits in...ambiguous problem solving and strategy setting to develop clinical program + Use data and insight to identify the… more