- AdventHealth (Maitland, FL)
- …coordinating depositions, and participation in any trial or hearing. . Audits existing Managed Care agreements for payer compliance with terms, timely ... This position will be responsible for execution of the managed care payor dispute resolution processes for...dispute resolution processes. The position reports to the Executive Director of Reimbursement and Compliance . Experience in… more
- Molina Healthcare (Orlando, FL)
- … healthcare experience + Understanding of the drivers and strategies across functions in managed care organizations (MCOs) as well as broad knowledge of the ... Duties** + Develops enterprise and domain-specific strategies to drive growth, compliance , and performance improvement within current business units + Leads… more
- Molina Healthcare (Orlando, FL)
- …* 3 years' experience in Utilization/Quality Program Management * 2+ years HMO/ Managed Care experience * Experience demonstrating strong management and ... dependency services and assists with implementing integrated Behavioral Health care management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization… more
- Black & Veatch (Orlando, FL)
- **Solution Sales Director - Sustainability, Planning & Optimization** Date: Apr 30, 2025 Location: US Company: Black & Veatch Family of Companies **Together, we own ... + Bachelor's degree or relevant work experience + Has successfully managed multiple engagements simultaneously + Contributor or leader to acquire new… more
- Molina Healthcare (Orlando, 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 ... for candidates living in the Eastern Time Zone. Regional Director Quality Solutions (QS) is responsible for contributing to...positions that are focused on Accreditation, Compliance , HEDIS Interventions, Potential Quality of Care … more
- AdventHealth (Orlando, FL)
- …and capacity to think strategically and implement tactically + Well versed in managed care and health policy + Experience with healthcare informatics, electronic ... coordinating and leading medical staff initiatives, cost-effective utilization, and compliance with regulatory standards. The ACMO provides leadership, strategic… more
- Molina Healthcare (Orlando, 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
- Molina Healthcare (Orlando, FL)
- …Knowledge and experience with value-based contracting. * In-depth knowledge of managed care business, regulatory/legal requirements, products, programs, strategy ... Develops the network, assuring network adequacy and access to member choice in compliance with federal and state laws. Negotiates and services larger and more… more
- AdventHealth (Maitland, FL)
- …and clinical departments * to keep them informed of any concerns related to managed care reimbursement and operational contract issues. * Ensures hospital staff, ... Precision of the contract build ensures payer accountability and compliance to the negotiated contract rates and terms. This...other products, policies and procedures that would impact the Managed Care team relative to processes and… more
- CenterWell (Deland, FL)
- …implements, analyzes, and organizes clinical operations for a specific location managed . + Conducts/delegates the assessment and reassessment of patients, including ... updating of care plans and interpreting patient needs, while adhering to...(POC). + Monitors cases to ensure documentation is in compliance with regulatory agencies and requirements of third-party payers.… more
- Marriott (Kissimmee, FL)
- …budget for associate health services * Acts as a liaison with benefit plans, health care providers, and managed care organizations and works in collaboration ... Bonus Eligible and Relocation Available **Job Number** 25059990 **Job Category** Health Care Services **Location** Gaylord Palms Resort & Convention Center, 6000 W.… more
- Molina Healthcare (Orlando, FL)
- …with regulatory reporting **PREFERRED EXPERIENCE:** * 2-4 experience working for a managed care organization * 3-5 years experience in healthcare industry ... to ensure Reporting and Triage activities are timely, accurate and in compliance with requirements prescribed by Molina Healthcare Inc., coordination with other… more
- AdventHealth (Davenport, FL)
- …date on hospital clinical quality, benchmarking, and best practices + Well versed in managed care and health policy . Ability to work effectively with hospital ... . Participates in the review long stay and/or complex care patients in conjunction with the director ...the Hospital Board for quality and safety of patient care . Assures medical staff compliance with CMS,… more
- Bristol Myers Squibb (Orlando, FL)
- …billing and payment + Medicare (NCD, IPPS, OPPS, 340B, etc.) + Medical policy, managed care coverage processes and practice for inpatient and outpatient settings ... within the assigned territory. The CMAM will report into the East Region Director , Cell Therapy Market Access Managers. The individual is required to achieve all… more
- ChenMed (Orlando, FL)
- …data and making decision based of the data + Experience working in Medicare managed care environment We're ChenMed and we're transforming healthcare for seniors ... you inspire others with your kindness and joy? We're different than most primary care providers. We're rapidly expanding and we need great people to join our team.… more
- Butterfly Effects (Orlando, FL)
- …behavior analysts (BCBA) and 800 behavior technicians. The 12 states we serve are locally managed by a regional director and team of BCBAs. Our corporate office ... affected by autism. Children and families are at the heart of our work, and we take care of the people who make all the difference - People like You! We have a… more