- CenterWell (Tallahassee, FL)
- …of our caring community and help us put health first** The Lead - Medicaid Customer Success oversees strategy and operations for multiple Medicaid markets. This ... contracts, as well as to identify opportunities and implement program improvements to enhance our member and customer experience....affairs teams, sales teams define overall strategy for each Medicaid state + Work with market partners to perform… 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
- CVS Health (Plantation, FL)
- …**Position Summary** **Aetna Better Health of Florida** (ABH-FL) is searching for a Senior Manager , Care Program Strategy who will be an analytics leader for ... specialty and chronic disease management care programs serving Medicaid and CHIP members. This role will focus on...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… 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
- CVS Health (Tallahassee, FL)
- …years of leadership experience + A minimum 3 years of experience in a Healthcare Program Integrity, Medicaid Special Investigation or Medicaid / Medicare / ... lost funds, and to comply with state regulations mandating fraud plans and reporting; Medicaid experience is preferred. Leads a team in the planning and execution of… 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 (Jacksonville, 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
- Devereux Advanced Behavioral Health (Orlando, FL)
- …inspired by helping others reach their potential? Join Devereux as a Revenue Cycle Manager !_ We are seeking a dynamic, positive Revenue Cycle Manager who ... the better! Located in Orlando, FL the Revenue Cycle Manager will be responsible for monitoring and reporting on...analysis. + Ensure accurate billing and claims submission for Medicaid , Managed Care, and other third-party payors + Hiring… more