- AdventHealth (Maitland, FL)
- …government and non-contracted products. Provides expert guidance to Regional Directors and Managed Care staff in reference to technical system and application ... Ensures thorough research and validation of non-contracted and government payer information * including regulatory and interim rate updates...and interim updates which may impact payers and products managed by other Managed Care … more
- AdventHealth (Maitland, FL)
- …School Grad or Equiv Required + 4 of experience in managed care , patient financial services or healthcare payer relations background Required . Certification ... and direction to PFS, Central Denials, Patient Access and Managed Care staff regarding contract terms and...Care Directors and Ancillaries. * Accountable for ensuring Payer updates (policy, system edits, operational changes, etc.) are… more
- AdventHealth (Maitland, FL)
- …the analysis and evaluation of financial and economic data related to healthcare costs and managed care payer rates and reimbursement. The role focuses on ... skills. The Medical Economics Manager will manage and mentor managed care staff for both the Florida and Multi-State Divisions of AdventHealth, as… more
- Amgen (Miami, FL)
- …stakeholders on disease state awareness and product information to support optimal patient care . As an Account Manager , you will drive product utilization while ... Services, MSLs, Nurse Educators, TLLs, Field Reimbursement]. + Strong knowledge of payer policies, reimbursement processes, and managed markets is a plus;… more
- Novo Nordisk (Holiday, FL)
- …in order to influence formulary status, as applicable + May analyze impact of managed care in the territory and its effect on prescribing decisions, and ... About the Department The Cardiometabolic Care Sales Team is at the forefront of...the CMCS I reports to the Portfolio District Business Manager of the specific sales territory. The CMCS I… more
- BayCare Health System (Sarasota, FL)
- …insurance, and benefit information. + Verifying insurance and benefits for all Medicare, Managed Care and Private Fee for Service Plans. Securing authorization ... system. + Timely requesting and communicating of authorizations to payer and documentation in EMR. + The Care...Coordination Assistant will work under the direction of the Care Transition Coordinator or RN Case Manager … more
- MyFlorida (Largo, FL)
- …billing. + Process monthly billing for all Medicare A&B, Medicaid, Medicaid Managed Care , Third Party Insurers, and any other payer for the State Veterans' ... Review and monitor resident accounts ensuring that the account set up and payer types have been correctly established by the facility. + Verify insurance… more
- HCA Healthcare (Fort Walton Beach, FL)
- …payer regulations and processes, and possesses a thorough understanding of managed - care concepts and length-of-stay management relating to patient and ... and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. +...psychosocial needs. + Obtains input from the RN case manager to ensure the discharge plan is appropriate and… more
- Elevance Health (Tampa, FL)
- …Financial, Business, and Leadership acumen strongly preferred. + Prior experience with managed care , trend & healthcare analytics, provider networks, claims, ... finance, and operations strongly preferred. + Healthcare payer experience strongly preferred. + Cost of ...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- PruittHealth (Tallahassee, FL)
- …offices. 7. Identifies key referring personnel in hospitals, nursing homes, and managed care operations, along with opportunities to increase referral volume ... to drive growth in our skilled nursing, rehabilitation and long-term care business. **KEY RESPONSIBILITIES:** 1. Develops, implements, and evaluates quarterly and… more
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