- 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
- 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
- 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
- AdventHealth (Maitland, FL)
- …coverage, payment, compliance, and basic billing rules for Government and Managed Care payers. Uses discretion when discussing personnel/patient related ... proper billing takes place on all assigned patient accounts. Depending on payer contract may be required to participate in conference calls, accounts receivable… 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
- 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
- AdventHealth (New Smyrna Beach, FL)
- …staff members and lower cost. Direct reports include Med Staff Manager + Clinical Effectiveness including performance improvement, infection control and regulatory ... compliance Risk Management Care Management including Clinical Documentation Integrity/CDMP **PRINCIPAL DUTIES AND JOB RESPONSIBILITIES** **:** Leads in the… more