- Molina Healthcare (Miami, FL)
- … healthcare experience + Understanding of the drivers and strategies across functions in managed care organizations (MCOs) as well as broad knowledge of the ... Summary** The role, reporting directly to the Head of Strategy , is a critical member of the Strategy... Strategy , is a critical member of the Strategy team, which supports senior executives in creating corporate,… more
- University of Miami (Medley, FL)
- …. The Department of Business Development and Managed Care is currently seeking an Executive Director , Managed ... work at our offices in Medley, Florida. The Executive Director , Managed Care Operations develops,...and collections activities, and counsels medical department leadership on managed care protocols and strategy .… more
- Molina Healthcare (Miami, FL)
- …with value-based contracting. * In-depth knowledge of managed care business, regulatory/legal requirements, products, programs, strategy and objectives. ... **Job Description** **Job Summary** Leads the market's strategy and planning in the successful development of the provider network, including development,… more
- ChenMed (Miami, FL)
- …of contact for ChenMed's sales strategy and overall growth performance with Medicare managed care plan executives, including both Value Based Care and ... need great people to join our team. The Senior Director , Payor Growth is a national leadership role and...business plans by aligning membership growth goals with contracted managed care plans. The person in this… more
- Molina Healthcare (Miami, FL)
- …and experience **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** * 8+ years of Medicaid managed care experience or in an equivalent related field * Ability ... with Medicaid Proposals and/or business development and requires demonstrated Medicaid managed care experience comprised of technical operational, sales, growth,… more
- Molina Healthcare (Miami, FL)
- …equivalent experience. **Required Experience** At least 7 - 10 years of experience in Managed Care and/or health plan quality. Clinical experience is needed for ... of Care issues, and medical record abstraction. Technical and strategy experience is needed for positions focused on interventions. **Preferred Education**… more
- Black & Veatch (Coral Gables, FL)
- **Solutions Sales Director - Industrial Cybersecurity** Date: Apr 29, 2025 Location: US Company: Black & Veatch Family of Companies **Together, we own our company, ... talents and perspectives to use. **The Opportunity** The Solution Sales Director for Industrial Cybersecurity will have the opportunity to coordinate internal… more
- Zimmer Biomet (Miami, FL)
- …effect action that will exploit the markets and actualize sales potential in the managed care arena. + Coordinates the development and application of appropriate ... Ambulatory Surgery Centers within assigned geography. + Accountable for contract strategy , customer negotiations, and pricing strategy for Ambulatory Surgery… more
- Molina Healthcare (Miami, FL)
- …experience. **Required Experience** 7 - 10 years minimum experience in Healthcare Administration, Managed Care , and/or Provider Network Mgmt & Operations with an ... of establishing a sufficient network of Participating Providers to serve the health care needs of Molina membership. * Develops and maintains a standard provider… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …+ Perform other projects, work, and activities as assigned by the Pharmacy Director Qualifications: + Managed Care experience preferred, but not ... Benefit Manager, New Contract Year formulary evaluation, and rebate strategy evaluation. The Clinical Pharmacist is the lead for...of, or currently enrolled in, residency program (PGY1) in managed care pharmacy, or pharmacy practice. +… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …coach patients to become self-advocates, and assist patients navigate the maze of the managed care delivery system. Essential Job Functions: + Assist SNP Case ... pertinent to patient's needs/goals. + Partners with the Program Director in development and review of the patient's individualized...navigator and point of contact for patients enrolled in managed care programs, assist patients with benefit… more
- Elevance Health (Miami, FL)
- …experience and requires a minimum of 2 years clinical, utilization review, or managed care experience; or any combination of education and experience, which ... treatment is medically necessary and provides consultation to Medical Director on cases that are unclear or do not...not be receiving appropriate type, level, or quality of care , eg, if services are not in line with… more
- Bristol Myers Squibb (Miami, FL)
- …billing and payment + Medicare (NCD, IPPS, OPPS, 340B, etc.) + Medical policy, managed care coverage processes and practice for inpatient and outpatient settings ... territory. The CMAM will report into the East Region Director , Cell Therapy Market Access Managers. The individual is...Operations, Cell Therapy Patient Support Services, Cell Therapy Access Strategy Team, and other matrix teams as needed to… more