- Cardinal Health (Tallahassee, FL)
- …companies (ex. Blue Cross, Blue Shield, IPA, etc). Reporting to the Director of Managed Care , the Manager of Contracting is responsible for managing ... **_What Managed Care contributes to Cardinal Health_**...other activity as it relates to payer interaction. The Manager of Payor Contracting is responsible for reviewing, auditing… more
- 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 ... or trends. Pivots detail for distribution to assigned Contract Manager or analyst. Contributes to the development and implementation...and interim updates which may impact payers and products managed by other Managed Care … more
- AdventHealth (Maitland, FL)
- …Provides guidance and direction to PFS, Central Denials, Patient Access and Managed Care staff regarding contract terms and policies including; governmental ... the Florida division. This position assists the Sr. Contract Manager with ensuring that preferred contract language provides for...key contract data elements which are populated into the Managed Care database including addition of new… more
- AdventHealth (Maitland, FL)
- …strong organizational skills. The Medical Economics Manager will manage and mentor managed care staff for both the Florida and Multi-State Divisions of ... FL **The role you will contribute:** A Medical Economics Manager is responsible for overseeing the analysis and evaluation...financial and economic data related to healthcare costs and managed care payer rates and reimbursement. The… more
- Molina Healthcare (Orlando, FL)
- …QUALIFICATIONS:** + At least 6 years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health plan setting, ... integrity issues, and process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape… more
- Molina Healthcare (St. Petersburg, FL)
- …years of experience in a pharmacy, Medication Therapy Management (MTM), Pharmacy Benefit Manager (PBM), and/or managed care setting, or equivalent combination ... Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care . **Essential Job… more
- Indeed (Miami, FL)
- …policy, and many region-specific benefits. **Benefits - Health, Work/Life Harmony, & Wellbeing** We care about what you care about. We have a multitude of ... benefits to support Indeedians, as well as their pets, kids, and partners including medical, dental, vision, disability and life insurance. Indeedians are able to enroll in our company's 401k plan, as well as an equity-based incentive program. Indeedians will… more
- Molina Healthcare (Miami, FL)
- …* At least 8 years clinical systems experience, preferably as a product owner / manager within a managed care , nursing informatics or health care ... implementation, and oversight of technology that drives core utilization management, care management, long-term services and supports (LTSS), clinical operations and… more
- Molina Healthcare (Jacksonville, FL)
- …Qualifications** * At least 3 years of experience in a pharmacy, Pharmacy Benefit Manager (PBM), formulary, and/or managed care setting, and 1-2 years ... team (ICT). * Works with the Pharmacy Benefit Manager (PBM) to manage formulary changes and update marketing...Qualifications** * Medicare Part D and/or Medicaid experience. * Managed care experience. To all current Molina… more
- MyFlorida (Tallahassee, FL)
- …of Floridians' health, health care services and costs, and is vital to managed care rate setting, health care economics, and health plan evaluation. ... 68046114 - ECONOMIST SUPERVISOR - SES / ACTUARIAL MANAGER Date: Sep 30, 2025 The State Personnel...and technical and analytical support with regards to the managed care rate setting process and methodologies… more