- Merck (Tallahassee, FL)
- …or reimbursement support * Strong knowledge of health insurance structures ( Medicare Part B, Medicaid, commercial) and related access processes, including ... benefit verification, prior authorization, and appeal processes * Expertise...by site or organization, with Friday designated as a remote -working day, unless business critical tasks require an on-site… more
- Baylor Scott & White Health (Tallahassee, FL)
- **JOB SUMMARY** 100% remote position** The Medical Trend Analytics Manager 1 is responsible for leading the design, execution, and communication of analytical ... excellent healthcare business acumen and communication skills. The Medical Trend Analytics Manager 1 manages a team that provides advanced medical cost trend… more
- Convey Health Solutions (Fort Lauderdale, FL)
- Job Description Job Title: Enterprise IT Support Manager Position Summary: The Enterprise IT Support Manager is responsible for the daily planning, operation, ... as well as data protection activities. The Enterprise IT Support Manager oversees service request and incident ticket systems, infrastructure monitoring tools,… more
- Bluestone Physician Services (Sarasota, FL)
- …medicare -26-6-million/) as measured by the overall savings per Medicare beneficiary. Position Overview : The Territory Manager ... In addition to fostering relationships with external stakeholders, the Territory Manager will work closely with internal stakeholders to coordinate future business… more
- Cognizant (Tallahassee, FL)
- …and member onboarding for individual, group, and government-sponsored health plans ( Medicare , Medicaid, ACA), ensuring compliance with CMS, ACA, and other regulatory ... flexibility wherever possible. Based on this role's business requirements, this is a remote position open to qualified applicants in the United States. Regardless of… more
- Humana (Tallahassee, FL)
- …us put health first Humana's Product organization is seeking a Lead Product Manager to drive the strategy, development, and optimization of the Adobe Experience ... frameworks and consent management best practices Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may… more
- CenterWell (Tallahassee, FL)
- …one of the largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the ... teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to… more
- CVS Health (Tallahassee, FL)
- …create a clinical operations plan. The Clinical Operations Advisor works with the Benefit Relationship Manager and client to facilitate gathering formulary and ... of business including Medicare , Medicaid, Exchange, and Commercial. This is a remote role, open to qualified candidates within the Central or Eastern time zones… more
- CenterWell (Tallahassee, FL)
- …one of the largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the ... in utilization management within Insurance industry a plus + Previous Medicare Advantage/ Medicare **Alert** Humana value's personal identity protection. Please… more
- CenterWell (Tallahassee, FL)
- …one of the largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the ... the Tele Sales Agents who are responsible for converting Medicare eligible callers to patients. The Care Delivery Call...PHI / HIPAA information Travel: While this is a remote position, occasional travel to Humana's offices for training… more