• Care Manager, LTSS field care in

    Molina Healthcare (Miami, FL)
    …ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost -effective member care . This position will ... JOB DESCRIPTION **Job Summary** The Care Manager, LTSS provides support for care...licensure and/or certification required ONLY if required by state contract , regulation or state board licensing mandates. If licensed,… more
    Molina Healthcare (12/24/25)
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  • Care Manager - Multiple Openings in FL (RN,…

    Molina Healthcare (FL)
    …ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost -effective member care . Essential Job ... JOB DESCRIPTION Job Summary Provides support for care management/ care coordination activities and collaborates...licensure and/or certification required ONLY if required by state contract , regulation or state board licensing mandates. * Valid… more
    Molina Healthcare (12/13/25)
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  • Government Operations Consultant II

    MyFlorida (Fort Lauderdale, FL)
    …of claims and provider reimbursement issues/complaints to determine managed care plan compliance with contract provisions. Coordinates and performs ... focused on advancing Governor DeSantis' vision for Florida's health care system to be the most cost -effective,...managed care plans related to compliance with contract provisions, provider reimbursement and claims processing… more
    MyFlorida (12/25/25)
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  • Government Operations Consultant II

    MyFlorida (Fort Lauderdale, FL)
    …of claims and provider reimbursement issues/complaints to determine managed care plan compliance with contract provisions. Coordinates and performs ... focused on advancing Governor DeSantis' vision for Florida's health care system to be the most cost -effective,...managed care plans related to compliance with contract provisions, provider reimbursement and claims processing… more
    MyFlorida (01/06/26)
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  • Senior Actuarial Analyst - Specialty Value Based…

    CVS Health (Tallahassee, FL)
    …from their analysis and develops recommendations to inform key decision makers + Provide input into performance monitoring and contract language to ensure ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
    CVS Health (12/17/25)
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  • Director Reimbursement Design & Market Evaluation

    Highmark Health (Tallahassee, FL)
    …and provider contracting or revenue management + 2 years Understanding of provider contract documents and overall contract management process **LICENSES ... a focus of innovation. + Develop and maintains strategic provider relationships to understand the current health care...of healthcare + Comfort and with real-time calculations of cost , membership, etc. (ie, "back of the envelope" estimations)… more
    Highmark Health (10/29/25)
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  • Senior Analyst, Network Strategy, Pricing…

    Molina Healthcare (Jacksonville, FL)
    …underperforming and problematic contracts. Supports multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by ... financial impact. * Work independently to support and validate Provider Network contracting and unit cost management...Provides peer review of team members' presentations for total cost of care and profit improvement initiatives… more
    Molina Healthcare (11/21/25)
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  • Senior Analyst, Network Strategy, Pricing…

    Molina Healthcare (Jacksonville, FL)
    …underperforming and problematic contracts. Supports multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by ... financial impact. + Work independently to support and validate Provider Network contracting and unit cost management...Provides peer review of team members' presentations for total cost of care and profit improvement initiatives… more
    Molina Healthcare (10/25/25)
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  • Network Relations Manager (Central and Northeast…

    CVS Health (Tallahassee, FL)
    contract language, service, claims or compensation issues, and provider education needs. + Optimizes interactions with assigned providers and internal ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
    CVS Health (11/30/25)
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  • Manager, Real Estate & Procurement

    Help at Home (Tallahassee, FL)
    **Overview** _Help at Home is the leading national provider of in-home personal care services, where our mission is to enable individuals to live with ... caregivers across 12 states. We're looking for people who care about others, who are willing to listen, lean...estate partner (Cushman & Wakefield), ensures effective vendor and contract management, and leverages the Coupa procurement system to… more
    Help at Home (01/06/26)
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