- AdventHealth (Maitland, FL)
- …anti-discrimination laws, regulations and ordinances._ **Category:** Revenue Cycle & Managed Care **Organization:** AdventHealth Corporate **Schedule:** Full ... + Conducts thorough research and validation of non-contracted and government payer information including regulatory and interim rate updates. **The expertise and… more
- J&J Family of Companies (Pompano Beach, FL)
- …solutions across multiple payer types and plans (ie, Medicare, Medicaid Managed Care , Commercial). + Execute business in accordance with the highest ... to address critical access and affordability issues for patients. + Partner with managed care colleagues to understand current policies and potential future… more
- CenterWell (Tallahassee, FL)
- …shared savings, episodic models, capitation, pay-for-performance). The role requires deep experience in payer or managed care contracting and the ability to ... of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing...impact** **Key Candidate Qualifications** + Required: 7+ years in payer or managed care contracting… more
- Cleveland Clinic (Stuart, FL)
- …planning, utilization management, Care Management, performance improvement and managed care reimbursement + Understanding of pre-acute and post-acute ... healthcare organizations in the world. The Lead RN Case Manager acts as the key information and education resource...skills, you will help to prepare a plan of care that is patient specific and coordinate with post-acute… more
- Molina Healthcare (Orlando, FL)
- …engagement or payer -provider program management. + Experience working in managed care , health plans, or healthcare networks (Medicaid, Medicare, ... relevant education and experience. + Operational Process Improvement experience. + Managed Care experience, preferably in a shared service, CoE or matrixed… more
- Help at Home (Tallahassee, FL)
- …and contact payer representatives to resolve issues as needed + Utilize payer portals, Managed Care Organization (MCO) provider phone lines, and ... and is responsible for performing data entry, authorization tracking, and payer communication functions within the Revenue Cycle Management Department. This position… more
- Boehringer Ingelheim (Orlando, FL)
- …depending upon geography. + Knowledge across portfolio is preferred. + Strong understanding of managed care and its impact on the industry. + Excellent judgment ... Manager ) at the Health System's various sites of care and with the Health Systems affiliated Health ...vehicle or authorized rental vehicle. + Strong understanding of managed care environment and intricacies of health… more
- Datavant (Tallahassee, FL)
- …will be responsible for reviewing and validating DRGs specific to Medicare and Medicare Managed Care . Interest in coding IP charts in the event the contract ... will be responsible for reviewing and validating DRGs specific to Medicare and Medicare Managed Care . Interest in coding IP charts in the event the contract… more
- AdventHealth (Tampa, FL)
- …for providing strategic direction for governmental and third-party payers in the managed care /commercial realm. This role actively plans, develops, organizes, ... federal programs, medicaid, or county state assistance knowledge [Required] + 5+ years of managed care experience in collections and billing operations or in a… 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
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