- Merck (Tallahassee, FL)
- …targeting and business analysis. + Articulates the complexities of the HIV payer environment, recognizing the role each stakeholder plays in the ability to ... and build partnerships with key stakeholders/departments. + Experience with complex payer environments, recognizing the role each stakeholder plays in the ability… more
- HCA Healthcare (Port St. Lucie, FL)
- …of hospital's peer review committees as requested. Business Development and Payer Relations + Evaluates clinical appropriateness of new medical technologies and ... and consultant to hospital case managers and hospital staff in the reduction of payer denials and in the denial and appeals process, as requested by the Case… more
- CenterWell (Tallahassee, FL)
- …leaders and champions to identify HEDIS gaps and deficiencies. + Participate in Payer calls/chart reviews. + Compile payer findings and assist with research. ... + Participate in payor meetings/discussions to ensure accurate data submission ** **Incumbent must reside in** **Palm Beach County** Hybrid role: Incumbent will work remotely; but will be required to visit centers based on the business need (ie every other… more
- BayCare Health System (Sarasota, FL)
- …provided by BayCare HomeCare from the payers. + Selecting the correct payer codes to provide accurate intake information. + Understanding medical criteria for ... into the EMR system. + Timely requesting and communicating of authorizations to payer and documentation in EMR. + The Care Coordination Assistant will work under… more
- Molina Healthcare (Orlando, FL)
- …Certification, Association** + Certified Risk Adjustment Coder - (CRC) + Certified Professional Payer - Payer (CPC-P) + Certified Coding Specialist - Physician ... based (CCS-P) To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal… more
- Adecco US, Inc. (Orlando, FL)
- …and appeals, ensuring timely patient access. 3. Design and deliver advanced payer insights tailored to provider needs, incorporating evolving policy trends and ... 7. Serve as a subject matter expert on Medicare and commercial payer structures, translating complex benefit data into actionable insights for stakeholders. 8.… more
- Pfizer (Tampa, FL)
- …expert. The Sr. Manager will partner closely with brand teams, USMA Payer Brand Marketers, Patient Services, SPP Strategy, BU Patient Solutions, legal, compliance, ... Strong financial competence and analytical skills + Experience in marketing, payer marketing, specialty pharmacy, strategic and tactical planning, and business… more
- Astellas Pharma (Pompano Beach, FL)
- …expert for compliant access and reimbursement topics. With expertise in payer coverage, healthcare payment models, and utilization management criteria (ie Prior ... partnership with internal matrix teams (including Sales, Key Account Management, and Payer Account Management) to create and regularly update Account Business Plans… more
- Cardinal Health (Tallahassee, FL)
- …need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient ... concerns in a timely manner + Mediate effective resolution for complex payer /pharmacy issues toward a positive outcome + Proactive follow-up with various contacts… more
- Walmart (Orlando, FL)
- …across Specialty Pharmacy operations, with a focus on process optimization, payer and pharmaceutical partner implementations, and technology deployment. This role ... or pharmacy environment. + Strong understanding of specialty pharmacy workflows, payer and pharma dynamics, and technology implementation best practices. +… more