- Elevance Health (Lake Mary, FL)
- …and use of proprietary data and claim systems for review of facility, professional and pharmacy claims. + Responsible for independently identifying and ... ** Pharmacy Investigator Senior** **Hybrid** : This role requires...insurance policies, health insurance claims handling and provider network contracting . + Develops and maintains a high degree of… more
- Elevance Health (Altamonte Springs, FL)
- **Manager Senior Engineering for Healthcare ( Pharmacy ) Applications** **Location:** This role requires associates to be in-office 2-3 days per week, fostering ... is granted as required by law. The **Manager Senior Engineering for Healthcare ( Pharmacy ) Applications i** s responsible for providing analytical support to the Cost… more
- Elevance Health (Miami, FL)
- **Staff Vice President (VP) Pharmacy Actuary** **Location** May be located in any Elevance Health PulsePoint office preferably in Indianapolis, IN, Atlanta, GA, ... 10+ direct reports / 20+ total FTE's **Position Responsibilities** + Complete pharmacy trend and rebate analytics for Medicaid, Medicare and/or Commercial and… more
- CenterWell (Tallahassee, FL)
- …community and help us put health first** The Provider Engagement Professional develops and grows positive, long-term relationships with physicians, providers and ... contracted working relationship with the health plan. The Provider Engagement Professional work assignments are varied and frequently require interpretation and… more
- Bausch + Lomb (Orlando, FL)
- …with various account types (HMO, PBM, GPO, Mail Service, VA/DOD, Drug Stores) + Pharmacy Benefit Contracting and Part D experience + Experienced in customer ... regional direct contracted accounts. + Collaborate with Patient Services, Contracting , Pricing, Payer Marketing and trade organizations on comprehensive strategies… more
- CVS Health (Tallahassee, FL)
- …overall professional work experience -8 years experience in specialty pharmacy , healthcare, contracting or pharmaceutical industry required. - Successful ... valuable services that differentiate us as a leading specialty pharmacy . Do you want to make a large impact...experience in business development and contracting , experience effectively presenting in front of large, executive… more
- Centene Corporation (Tallahassee, FL)
- …one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national ... opportunities for purchasing generics/ biosimilars. Analyze data from AcariaHealth and Centene Pharmacy Services and collaborate with internal pharmacy teams to… more
- Travelers Insurance Company (Tallahassee, FL)
- …collaboration with the Claim leaders and in partnership with other Medical and Pharmacy professionals. **What Will You Do?** + Provide overall program leadership as ... trends. + Attend external forums representing Travelers. Function as a liaison and professional relations contact on a local and national level. + May provide input… more
- Immigration and Customs Enforcement (Miami, FL)
- …addresses discrepancies prior to validation. Collaborates with the headquarters contracting officer representative (COR) to ensure compliance with Federal ... records management, clinical services, nursing services, mental health services, pharmacy services, dental services, medical records, and administration; quality… more
- CenterWell (Tallahassee, FL)
- …of eight years of progressive experience in provider network management, provider contracting , quality + A minimum of five years formal leadership experience; ... + Prior work experience in value-based care; practice management and/or payer contracting with demonstrated success directing and leading teams + Proven ability to… more
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