- Prime Therapeutics (Tallahassee, FL)
- …and drives every decision we make. **Job Posting Title** AVP Account Management - REMOTE (FL Preferred) **Job Description** The Assistant Vice President Client ... business (Employer Markets, Health Insurance Marketplace (HIM), Commercial, Medicare, and Medicaid ). This individual is the primary relationship and contract owner… more
- Humana (Tallahassee, FL)
- …first? During the period of this unpaid internship, you will work with the Medicaid Clinical Services team to ensure interaction between the company and members are ... with an opportunity to train and work with Humana's Medicaid Team for the Applied Behavioral Analysis, (ABA) contract...and engage formerly acquired skillsets to: + Perform care management of pediatric members (under 21) who utilize Applied… more
- CVS Health (Tallahassee, FL)
- …of Nursing experience. Preferred Qualifications + Prior authorization utilization management / review experience preferred Outpatient Clinical experience. + ... skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for… more
- Prime Therapeutics (Tallahassee, FL)
- …help ensure efficient and effective solutions are implemented + Perform and review detail plans to address complex compliance issues by identifying goals, ... + Oversee the implementation and maintenance of Compliance system modules + Monitor system performance and make recommendations for improvements. + Other duties as… more
- Prime Therapeutics (Tallahassee, FL)
- …+ Provide work plan and detailed estimate, based on scope; drive scope management , prioritization and scope trade off discussions with project teams + Interview ... signoff of deliverables by all impacted parties + Facilitate solution design review discussions between IT resources and business requestors to resolve questions… more
- Datavant (Tallahassee, FL)
- …and support value-based client delivery across Medicare Advantage, ACA, and Medicaid programs. The ideal candidate combines deep healthcare analytics expertise with ... strong product management skills, and thrives at the intersection of product,...impact, client value, and strategic alignment. + Define and monitor KPIs such as suspecting accuracy, chart throughput, RAF… more
- Prime Therapeutics (Tallahassee, FL)
- …within their designated areas and partners with key internal stakeholders to monitor aspects of compliance and validate policies, procedures, support and review ... and triages inquiries, requests and escalations to appropriate staff or management + Develop solutions to moderately complex compliance problems by referring… more
- Prime Therapeutics (Tallahassee, FL)
- …teams, ensuring adequate representation for market-specific client needs; align account management activities across all lines of business and develop methodologies, ... client and ensure retention of key account + Collaborate across Account Management support and operations teams to establish key performance indicators and reporting… more
- CenterWell (Tallahassee, FL)
- …in a Specialty Pharmacy setting + Previous experience with pharmacy benefits management + Previous Commercial, Medicare and/or Medicaid experience + Previous ... Additionally, you will develop and implement comprehensive care plans, monitor patient progress through regular assessments, and utilize advanced telecommunication… more
- Cardinal Health (Tallahassee, FL)
- …benefits management experience preferred with specific knowledge of Medicare, Medicaid and commercially insured payer common practices and policies, preferred * ... get life-changing therapies** **to** **patients who need them-faster.** **_Responsibilities_** * Monitor system accounts for new Patient cases * Conduct outbound… more
- Highmark Health (Tallahassee, FL)
- …and interventions accurately and completely in the appropriate systems. + Monitor member medication adherence through claims data analysis and other available ... report improper coordination of benefit billing practices through paid claims review . + Complete other assigned duties as specified. + **QUALIFICATIONS** **Minimum**… more