- PharmaCord (Orlando, FL)
- When you join the team as an Executive Case Manager , you'll have the opportunity to make a difference in the lives of our patients each day as they look to you as ... prescriptions or cases are handled in a timely manner. An Executive Case Manager has the ability to translate knowledge into patient friendly language and education.… more
- 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
- AdventHealth (Altamonte Springs, FL)
- …**Responsible for ensuring the providers are loaded timely and accurately with Managed Care contracted payers. Responsible for evaluating professional fee ... (PE) and works closely with practice office operations staff, Managed Care (MC) contracting, MC Credentialing and...+ Completes special projects as assigned by the reimbursement manager within the time frame requested. **The expertise and… more
- Molina Healthcare (Miami, 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
- Molina Healthcare (Orlando, FL)
- …Nursing preferred. **Required Experience** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **Required ... in Nursing **Preferred Experience** 3-5 years in case management, disease management, managed care or medical or behavioral health settings. Preferred License,… more
- ChenMed (Largo, FL)
- …Commission for Case Manager Certification (CCMC) or the American Association of Managed Care Nurses (CMCN) desired + This position requires possession and ... expanding and we need great people to join our team. The Intensive Community Care Manager (ICCM) is a Registered Nurse (RN) who works with our highest complexity… more
- Option Care Health (Port St. Lucie, FL)
- …Option Care . Description of available services is accurate. Meets with managed care organizations and other accounts to facilitate education regarding ... no limit to the growth of your career.** Option Care Health, Inc. is the largest independent home and...brightest talent in healthcare. **Job Description Summary:** The Pharmacy Manager is a licensed professional who is responsible for… more
- Humana (Tallahassee, FL)
- …+ BSN or MSN degree + Knowledge of Milliman or Interqual + Managed care experience + Certified Case Manager (CCM) + Bilingual in English and Spanish (see ... part of our caring community and help us put health first** The Care Manager , Telephonic Nurse 2, in a telephonic environment, assesses and evaluates members'… more
- CenterWell (Tampa, FL)
- **Become a part of our caring community and help us put health first** The Manager Care /Case Management in **Tampa area (** **_this is not a remote position_** ... coordinating care to reduce acute and post-acute care utilization. The Manager role is hybrid...business health field + Previous experience working in a managed care field + 5 or more… more
- Molina Healthcare (Miami, FL)
- …(LPN) Program **REQUIRED EXPERIENCE:** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **REQUIRED ... in OB HIGH RISK / maternal health case management, disease management, managed care or medical or behavioral health settings. To all current Molina employees:… more
- Cleveland Clinic (Port Saint Lucie, FL)
- …and procedures for utilization review and discharge planning, ensuring compliance with managed care contracts and Medicare regulations. + Analyze productivity ... and find where you belong, here at Tradition Hospital. As a Manager of Care Management, you will supervise care managers, clinical referral coordinators,… more
- Amgen (Jacksonville, FL)
- …2 years of public or private third-party access arena or pharmaceutical industry in sales, managed care , or clinical support OR Master's degree AND 4 years of ... lives of patients while transforming your career. **Field Reimbursement Manager , Senior Manager - South East** **What...private third-party access arena or pharmaceutical industry in sales, managed care , or clinical support OR Bachelor's… more
