- Zurich NA (Tallahassee, FL)
- Managed Care , Claims Vendor Management Sr Specialist 118916 Zurich North America is seeking a Managed Care , Claims Vendor Management ... United States. **About the Role** As a Senior Specialist in Managed Care and Claims Vendor Management, you will play a key role in administering… more
- MyFlorida (Tallahassee, FL)
- …waivers and home and community based waivers), administrative rules, coverage policies, managed care plan contracts, bill analyses, drug utilization review ... 21. This position is responsible for development of policy language for Statewide Medicaid Managed Care (SMMC) Plan Communications (ie, Dear Managed Care… more
- Evolent (Tallahassee, FL)
- …experience in claims -based healthcare analytics with a payer, provider, clinical vendor , managed care , or related healthcare consulting entity- ... people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care … more
- Humana (Tallahassee, FL)
- …7+ years of related compliance and/or special investigation experience in managed care or CMS. + Prior health insurance claims experience + Demonstrated ... Attend federal CMS and state fraud meetings with other managed care organizations, as well as state...exciting interviewing technology provided by Modern Hire, a third-party vendor . This technology provides our team of recruiters and… more
- HealthEdge Software Inc (Tallahassee, FL)
- …Practical understanding of the healthcare system with regards to Medicare, Medicaid, managed care , and commercial payment methodologies, payment integrity, and ... and maintenance of provider rate and/or claim editing provisions in a claims adjudication system and/or third-party vendor application. + Working knowledge… more
- Takeda Pharmaceuticals (Tallahassee, FL)
- … Vendor Management + Oversight and accountability for labeling activities managed by external vendor (s) for assigned products, ensuring seamless coordination, ... labeling requirements to be provided to patients and Health Care Providers while minimizing the risk of write-offs. +...to ensure consistency with the overall product strategy, product claims and information in the CCDS and to ensure… more
- Centene Corporation (Tallahassee, FL)
- …the following:** Medicare, Medicaid, PDP, Exchange etc. Preferred Other Experience in health care or managed care environment **Preferred Other Experience ... in the following areas:** Benefits, Healthcare or Regulatory/Government Affairs Vendor management or oversight; preferably with healthcare vendors **Preferred 1+… more