- Prime Therapeutics (Tallahassee, FL)
- … business (Employer Markets, Health Insurance Marketplace, Commercial, Medicare, Medicaid , Specialty) or with unique Prime contract requirements; drive the ... we make. **Job Posting Title** Health Plan Account Dir Sr - Remote **Job Description** The Sr ...advanced degree + Experience working within assigned line of business or market segment (Commercial, Medicare, Medicaid ,… more
- Prime Therapeutics (Tallahassee, FL)
- …passion and drives every decision we make. **Job Posting Title** Regulatory Analyst Sr - Remote **Job Description** The Senior Regulatory Analyst is responsible ... and participates in committee review meetings within the Commercial, Medicare, Medicaid , and Health Insurance Marketplace for the assigned department. This position… more
- Humana (Tallahassee, FL)
- …Medicaid products and capabilities to support the strategic direction and growth of the Medicaid and Duals lines of business . This is a unique opportunity for ... Care Organization **OR** 2+ years of experience in strategy consulting supporting Medicaid managed care organizations. + Experience in business development or… more
- Public Consulting Group (Tallahassee, FL)
- …and Grants Management + Assessments and Feasibility Studies PCG is looking for a Senior Consultant in Medicaid policy and funding as it relates to children's ... Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health,...children's behavioral health services. PCG is looking for a Senior Consultant in Medicaid policy and funding… more
- Prime Therapeutics (Tallahassee, FL)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Sr . Director, Pharmacy Network Management - Remote **Job Description** The Senior ... market leading pharmacy reimbursement methodologies that support all of Prime's business assuring coordination with performance standards and corporate goals. + Lead… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Senior Vice President (SVP), Medicaid Divisional Leader, will serve as the Divisional ... executive will be responsible to oversee all stages of market maturity uniting business development, active implementation , and established markets for end to… more
- CVS Health (Tallahassee, FL)
- …strategic provider Medicaid relationships as part of the National VBC Business Development team. You will work collaboratively across the Network and Medicaid ... of value-based contract relationships, serving as SME in support of business strategies across the Medicaid segment. + Develops relationships with… more
- Humana (Tallahassee, FL)
- …an in-depth evaluation of variable factors. The Senior Technology Implementation Professional gathers and documents business system and functional ... a part of our caring community and help us put health first** The Senior Technology Implementation Professional delivers new technological solutions to meet … more
- MyFlorida (Tallahassee, FL)
- 68064375 - SENIOR HUMAN SERVICES PROGRAM SPECIALIST Date: Nov 1, 2024 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... 838780 Agency: Agency for Health Care Administration Working Title: 68064375 - SENIOR HUMAN SERVICES PROGRAM SPECIALIST Pay Plan: Career Service Position Number:… more
- Humana (Tallahassee, FL)
- …be responsible for meticulously reviewing regulatory changes and new rules pertinent to the Medicaid line of business . Your primary focus will be to identify ... requirements and assess potential impacts on various business areas. **Location:** remote The Senior Risk...reviewing regulatory changes and new rules pertinent to the Medicaid line of business . Your primary focus… more
- CVS Health (Tallahassee, FL)
- …expectations for demonstrating quality outcomes, including NCQA and state regulators for Medicaid and CHIP. Links the quality management activities to business ... innovation, integration, and information. Participates in the development and ongoing implementation of Quality Management (QM) work plans and activities, including… more
- Humana (Tallahassee, FL)
- …Coordinate business partner engagement with external regulators + Coordinate implementation and compliance with corrective action plans, as needed + Provide ... a part of our caring community and help us put health first** This Senior Compliance Professional role supports Humana's suite of Medicare and Commercial Dental and… more
- HealthEdge Software Inc (Tallahassee, FL)
- **Overview** **Position Overview:** We are seeking a Senior Payment Integrity Specialist to play a key role in building and implementing proprietary healthcare edits ... in claims processing. The successful candidate will be responsible for taking a senior level role in analyzing claims data, as well as translating contract terms,… more
- Humana (Tallahassee, FL)
- …our caring community and help us put health first** The Service Fund Senior Value-Based Programs Analyst supports our Market and Provider partners through ensuring ... with the Market partners to ensure understanding and accuracy. The Senior Value-Based Programs Analyst work assignments involve moderately complex to complex… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Senior IT Product Owner (PO) role is responsible for managing and communicating the vision ... to the team to determine the HOW. The role drives value to the business by building and maintaining a product backlog in collaboration with stakeholder and delivery… more
- CVS Health (Tallahassee, FL)
- … implementation experience (2-4 years) * Experience with Medicare, Medicaid or Exchange Enrollment, Billing and Correspondence Operations (2-4 years) * ... a Scrum Team role that will be a member of the Medicare / Medicaid / Exchange Enrollment Configuration team tasked with developing purpose-built capabilities for our… more
- Prime Therapeutics (Tallahassee, FL)
- …product domain and may align activities around a specific line of business (MedD, Medicaid , Health Insurance Marketplace, Commercial). **Responsibilities** + ... departmental strategy and new clinical product offerings (ie project representation across business units) + Represent the domain in partnership with key internal… more
- Humana (Tallahassee, FL)
- …experience. The individual in this role will lead Humana network infrastructure implementation for Google Cloud. The Lead Cloud Solutions Engineer (Network) performs ... to ensure an integrated architecture across interdependent technologies. Works with senior executives to develop and drive segment or enterprise-wide functional… more