- Prime Therapeutics (Tallahassee, FL)
- …us. **Job Posting Title** Georgia Medicaid Clinical Account Manager - Remote **Job Description** Innovative business clinician accountable for building and ... fashion. + Demonstrates the value of pharmacy solutions (unit cost, utilization management & patient care enhancement). + Identifies opportunities for additional… more
- Prime Therapeutics (Tallahassee, FL)
- …of pharmacy with us. **Job Posting Title** Clinical Account Director - Remote **Job Description** The Clinical Account Director is responsible for the management ... specific clinical programs and drug strategy recommendations including drug formulary, Utilization Management programs, and other drug therapy related products and… more
- Prime Therapeutics (Tallahassee, FL)
- …pharmacy with us. **Job Posting Title** Network Management Consultant - Remote **Job Description** The Network Management Consultant is responsible for development, ... to update contract documents including agreements and applications for utilization in contracting/re-contracting activities based on new network participation… more
- Molina Healthcare (Jacksonville, FL)
- …team and key stakeholder meetings (PowerPoint) * Coordinates and provides peer review of our quarterly national contract performance analysis by team members to ... stakeholders requiring decision support. * Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on… more
- Molina Healthcare (Jacksonville, FL)
- …team and key stakeholder meetings (PowerPoint) + Coordinates and provides peer review of our quarterly national contract performance analysis by team members to ... stakeholders requiring decision support. + Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on… more
- Molina Healthcare (Orlando, FL)
- …a (RN) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity of high speed required Work Schedule ... on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. JOB DESCRIPTION Job SummaryProvides support for clinical member… more
- RxBenefits (Jacksonville, FL)
- …channel management, B/G classifications, specialty designations, rebate eligibility, utilization trend, Utilization Management (UM) implications, Manufacturer ... structure, new prospect member size, marketing agreements, broker commissions, and drug utilization . + Be the SME on dozens of medical vendor/PBM contracts including… more
- Humana (Tallahassee, FL)
- …of program changes and outcomes. Responsibilities include: + Oversee the development, review , and maintenance of Utilization Management (UM) policies and ... ranging from moderate to substantial. The Policy Governance Lead for Utilization Management (UM) is responsible for overseeing the development, implementation, and… more
- Humana (Tallahassee, FL)
- …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all… more
- Olsson (Tallahassee, FL)
- BMS Engineering Leader - Data Center Arizona - Remote ; Arkansas - Remote ; Florida - Remote ; Georgia - Remote ; Idaho - Remote ; Illinois - Remote ; ... Remote ; Iowa - Remote ; Kansas - Remote ; Kentucky - Remote ; Louisiana - ...Monitor and enhance the group's project performance and employee utilization and workload, identifying potential areas of improvement and… more