- Humana (Tallahassee, FL)
- …Staff + Works closely with internal stakeholders including Finance, Actuarial, Clinical, Medicare Risk Adjustment, Provider Contracting , and Provider ... Vice President of Operations in support of the Medicare Advantage line of business. The Market Finance Lead...and leaders, as well as some visibility to external provider partners + Advises regional leadership of… more
- BD (Becton, Dickinson and Company) (Stuart, FL)
- …establishment, development and execution of the payor, managed care, and payer contracting medical policy initiatives in collaboration with BD's market access and ... to ensure optimal coverage and maximize reimbursement from Commercial, Medicaid and Medicare plans. The individual will also have direct supervision of the contract… more
- Molina Healthcare (Tampa, FL)
- …management policies and procedures to improve quality outcomes and decrease costs. * Provide regional medical necessity reviews and cross coverage * Standardizes ... Medicare . **Preferred Experience** * Peer Review, medical policy/procedure development, provider contracting experience. * Experience with NCQA, HEDIS,… more
- Centene Corporation (Tallahassee, FL)
- …preferred. Preferred knowledge of modern business intelligence and visualization tools. ** Provider :** Experience in provider contracting , claims pricing, ... + Interpret and analyze data from multiple sources including healthcare provider , member/patient, and third-party data. + Support execution of large-scale projects… more