- Centene Corporation (Tallahassee, FL)
- …management activities to ensure compliance with current state, federal, and third-party payer regulators + May perform on-site visits to assess member's needs and ... collaborate with providers or resources, as appropriate + May provide education to care manager and/or members and their families/caregivers on procedures, healthcare provider instructions, care options, referrals, and healthcare benefits + Other duties or… more
- University of Miami (Doral, FL)
- …OP Time, Care Everywhere, Resolute, Real Time Eligibility, UHealth Contract Summary, Payer Websites, Nice in Contact Communication, and Aria Oncology. + Works with ... Leadership on strategy plan for growth and expansion opportunities that will drive business results including increase in revenues and meeting market needs for patient demands. + Oversees and supports remote patient access functions including but not limited… more
- Cognizant (Tallahassee, FL)
- …ensure accurate and timely adjudication of professional and hospital claims utilizing payer specific policies and procedures. Provide support to claims and client ... issues related to claims adjudication and adjustments. Service Now and Inquiry resolution, and any basic questions regarding health coverage as stated in the employer's plan document. You will be valued member of the Cognizant team and collaborate with… more
- University of Miami (Miami, FL)
- …Medicare Co-insurance and Advance Beneficiary Notices, and Medicare Secondary Payer Questionnaire. + Serves as gatekeeper, performs insurance verification, and ... obtains referrals and/or authorizations as needed. + Provides financial counseling services at check-in, explains benefits, creates estimates, and notifies patients of self-pay liabilities including co-pays, deductibles, co-insurances, global self-pay… more
- Acxiom (Tallahassee, FL)
- …Comprehensive knowledge and deep understanding of the Healthcare industry including payer , provider and life science. Possess specialized insights, and a nuanced ... understanding of the market dynamics, trends, challenges, regulations, and competitive landscape. **DUTIES AND RESPONSIBILITIES:** + Achieves and exceeds revenue growth targets, maintains revenue run rate, profitability targets, and other sales related goals… more
- Sumitomo Pharma (Tallahassee, FL)
- …SHA, MMIT/DRG formulary / market access data). + Solid understanding how brand payer access impacts sales strategy and field pull through tactics. + Proven success ... in developing analyses with Business Intelligence tools and methods (eg, Tableau, Qlikview, SQL). + Excellent team player and collaborative skills. + Strong demonstrated project management skills and managing external vendors/ deliverables within tight… more
- Norstella (Tallahassee, FL)
- …or expanding our solutions in long term partnerships. Solution Consultants infuse deep payer and data expertise into the sales process and they lead the capabilities ... portion of every sales engagement with a strong point of view by showcasing MMIT's offerings with use case scenarios. Solutions Consultants collaborate with our VP level sales executives in applying MMIT's solutions to pharmaceutical manufacturers, managed… more
- Prime Therapeutics (Tallahassee, FL)
- …and relationship management abilities + Knowledge of healthcare regulations, payer strategies, and compliance requirements + Proficient in Microsoft products, ... including excel and PowerPoint + Ability to manage complex projects across the enterprise through cross-collaboration **Preferred Qualifications** + Master's degree in Business Administration or Public Health or Oncology Pharmacy Specialty Certification BCOP +… more
- HCA Healthcare (Plantation, FL)
- …thorough working knowledge of the rules of Medicare, Medicaid, and private payer regulations and processes. You will possess a thorough understanding of managed-care ... concepts and length-of-stay management relating to patient and organizational fiscal responsibility. + You will perform thorough assessments and develop appropriate discharge plans for high-risk patients with discharge planning or psychosocial needs. + You… more
- Ascension Health (Jacksonville, FL)
- …and new fees. + Act as a resource for information on public/private payer assistance and guidelines. + Research reimbursement issues as necessary. + Train and ... coach staff regarding proper coding and reimbursement policies and procedures. **Requirements** Education: + High School diploma equivalency OR 1 year of applicable cumulative job specific experience required. + Note: Required professional… more