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Manager Remote Managed Care Jobs in Florida (NOW HIRING)

Ensign Services, Inc.

Managed Care Resource

Orlando, FL · On-site +1

Managed Care Resource - Southeast Region Position Type: Full-time, exempt employee. Compensation Range: Depending on Experience. Location: Candidate must reside in the Orlando, Florida area. About ...

BayCare

Managed Care Negotiator I

Clearwater, FL · Remote

Remote must reside in Florida * Status: Full Time (non-exempt) * Shift: 8:00 AM - 5:00 PM (may vary ... Negotiates agreements under supervision from manager and/or director. * Supports managed care ...

Aquatis LLC

Sales Manager (Remote)

Kissimmee, FL · Remote

United States - Sales Manager (Remote) Interested in generating sales for Aquatis? Looking to learn and develop your sales experience? We think we could help! Aquatis LLC is searching for brand new ...

Aquatis LLC

Sales Manager (Remote)

Kissimmee, FL · On-site +1

United States - Sales Manager (Remote) Interested in generating sales for Aquatis? Looking to learn and develop your sales experience? We think we could help! Aquatis LLC is searching for brand new ...

HMG Careers

Sales Manager Remote

Aventura, FL · Remote

$69K/yr

Remote Insurance Sales Representative | Flexible Schedule | Commission-Based This position offers flexible work hours and clear paths for advancement into leadership and management. You will work ...

HMG Careers

Sales Manager Remote

Tamarac, FL · Remote

$69K/yr

Remote Insurance Sales Representative | Flexible Schedule | Commission-Based This position offers flexible work hours and clear paths for advancement into leadership and management. You will work ...

HMG Careers

Sales Manager Remote

FL · Remote

$69K/yr

Remote Insurance Sales Representative | Flexible Schedule | Commission-Based This position offers flexible work hours and clear paths for advancement into leadership and management. You will work ...

HMG Careers

Sales Manager Remote

Pensacola, FL · Remote

$69K/yr

Remote Insurance Sales Representative | Flexible Schedule | Commission-Based This position offers flexible work hours and clear paths for advancement into leadership and management. You will work ...

HMG Careers

Sales Manager Remote

Cape Coral, FL · Remote

$69K/yr

Remote Insurance Sales Representative | Flexible Schedule | Commission-Based This position offers flexible work hours and clear paths for advancement into leadership and management. You will work ...

HMG Careers

Sales Manager Remote

Miami, FL · Remote

$69K/yr

Remote Insurance Sales Representative | Flexible Schedule | Commission-Based This position offers flexible work hours and clear paths for advancement into leadership and management. You will work ...

HMG Careers

Sales Manager Remote

Miami, FL · Remote

$69K/yr

Remote Insurance Sales Representative | Flexible Schedule | Commission-Based This position offers flexible work hours and clear paths for advancement into leadership and management. You will work ...

HMG Careers

$69K/yr

Remote Insurance Sales Representative | Flexible Schedule | Commission-Based This position offers flexible work hours and clear paths for advancement into leadership and management. You will work ...

HMG Careers

$69K/yr

Remote Insurance Sales Representative | Flexible Schedule | Commission-Based This position offers flexible work hours and clear paths for advancement into leadership and management. You will work ...

HMG Careers

Sales Manager Remote

West Palm Beach, FL · Remote

$69K/yr

Remote Insurance Sales Representative | Flexible Schedule | Commission-Based This position offers flexible work hours and clear paths for advancement into leadership and management. You will work ...

HMG Careers

Sales Manager Remote

Leesburg, FL · Remote

$69K/yr

Remote Insurance Sales Representative | Flexible Schedule | Commission-Based This position offers flexible work hours and clear paths for advancement into leadership and management. You will work ...

HMG Careers

Sales Manager Remote

Margate, FL · Remote

$69K/yr

Remote Insurance Sales Representative | Flexible Schedule | Commission-Based This position offers flexible work hours and clear paths for advancement into leadership and management. You will work ...

HMG Careers

Sales Manager Remote

Lauderdale Lakes, FL · Remote

$69K/yr

Remote Insurance Sales Representative | Flexible Schedule | Commission-Based This position offers flexible work hours and clear paths for advancement into leadership and management. You will work ...

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Showing results 1-20

All JobsManaged Care JobsManager Remote Managed Care JobsManager Remote Managed Care Jobs in Florida

Manager Remote Managed Care information

What is a manager remote managed care?

Manager Remote Managed Care roles involve overseeing the delivery and coordination of managed healthcare services, typically from a remote location. These managers are responsible for ensuring that patients receive appropriate, cost-effective care through provider networks, utilization management, and compliance with insurance policies. They often lead teams that handle case management, claims review, and quality assurance, working closely with healthcare providers, insurance companies, and patients. The remote aspect of this job allows managers to fulfill these responsibilities from home or another off-site location using digital communication tools.

How does a manager remote managed care typically collaborate with cross-functional teams to ensure optimal patient outcomes?

As a Manager Remote Managed Care, you will regularly collaborate with clinical teams, case managers, and insurance representatives to coordinate patient care and manage utilization. This role often requires facilitating virtual meetings, analyzing care data, and ensuring compliance with healthcare regulations across multiple departments. Effective communication and organizational skills are essential, as you’ll be the key link between remote staff, providers, and payers to optimize patient outcomes and streamline processes.

What is the difference between Manager Remote Managed Care vs Managed Care Coordinator?

AspectManager Remote Managed CareManaged Care Coordinator
Primary RoleOversees managed care programs, develops strategies, manages teamsCoordinates patient care, processes authorizations, supports case management
CredentialsTypically requires a bachelor’s degree, relevant certifications (e.g., CCM)Often requires a bachelor’s degree, certification preferred
Work EnvironmentRemote, office-based, healthcare organizationsRemote or onsite, healthcare facilities or insurance companies
Industry UsageCommon in health insurance, healthcare managementCommon in health plans, case management, healthcare providers

The Manager Remote Managed Care focuses on overseeing managed care programs and leading teams remotely, while the Managed Care Coordinator handles patient-specific tasks like authorizations and care coordination. Both roles require relevant healthcare credentials and are integral to healthcare organizations, but they differ in scope and responsibilities.

What are the most commonly searched types of Remote Managed Care jobs in Florida?

The most popular types of Remote Managed Care jobs in Florida are:

What cities in Florida are hiring for Manager Remote Managed Care jobs?

Cities in Florida with the most Manager Remote Managed Care job openings:

Manager Remote Managed Care jobs near you

Managed Care Resource

Ensign Services, Inc.

Orlando, FL • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 20 days ago

Ensign Group rating

6.5

Company rating: 6.5 out of 10

Based on 168 frontline employees who took The Breakroom Quiz

611th of 895 rated healthcare providers

Job description

Managed Care Resource - Southeast Region
Position Type: Full-time, exempt employee.
Compensation Range: Depending on Experience.
Location: Candidate must reside in the Orlando, Florida area.
About the Company:
Ensign Services, Inc. ("ESI") is a subsidiary of The Ensign Group, Inc. whose affiliated entities are considered national leaders in the fast-growing post-acute care industry. ESI provides service and support to over 378 facilities in the long-term care continuum that employ over 55,000 employees.
ESI is known as the "Service Center" and provides the facilities and leaders it serves with "back-office" support in areas such as accounting, construction, compliance, human resources, information technology, learning and development, legal and risk management and recruiting. This structure allows the onsite leaders and caregivers to focus on day-to-day care and operational issues in their individual operations. What sets ESI apart from other companies is the quality of our most valuable resource - our people.
We take our core values of Celebration, Accountability, Passion for Learning, Love One Another, Intelligent Risk Taking, Customer Second, and Ownership ("CAPLICO") seriously. We want an individual in this role who will demonstrate these values through actions and words.
About the Opportunity:
The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the healthcare industry. The Consultant will provide guidance regarding development of managed care relationships and rate negotiation, ensuring timeliness and rate appropriateness. Additionally, the Consultant will negotiate contracts for new locations, assist with ensuring that contracts are updated for new services and help with contract cancellations, denials and appeals.
Job Duties and Responsibilities include, but are not limited to:
  • Establish, implement and evaluate the strategic plan(s) that will ensure each local operation the ability to optimize financial performance through rates and increased census.
  • Engage in complex levels of contract development and negotiation, including risk agreements using utilization, claims and market data with health plans and direct service agreements with physicians, physician organizations and hospitals and ancillary providers.
  • Identify, develop and maintain an effective relationship with contracted health plans and managed care regulatory agencies.
  • Manage complex and high-profile health plan negotiations. Actively draft and negotiate contracts in the health care operations and health care plan functional areas.
  • Assist in analysis and coordination of amendments, reimbursement, and language changes.
  • Assess resource utilization, cost management and negotiate effectively.
  • Monitor industry changes, trends and events to proactively identify opportunities to increase market penetration and performance improvement.
  • Understands the competitive pricing levels in the local market and improves the company's cost position through unit costs strategies.
  • Strategizes for facility census growth and retention.
  • Teach, Train and Instruct facility level personnel on how to operationalize the contract.
  • Interact with facility personnel on utilization, clinical results and managed care census.

Preferred Qualifications:
  • A bachelor's degree in business administration, management or health care administration, highly desired.
  • At least 2 years of experience with Managed Care contracting, highly desired.
  • Must reside in Florida, preferably in the Orlando area.
  • Willing to travel up to 80% of the time (as deemed appropriate).
  • Knowledge of managed care contracting language, requirements, and methods to support the development and maintenance of contract compliance, contract language review and contract analysis.
  • Must be knowledgeable about the managed care environment, including capitation, PPO, HMO, IPA, ACO and POS.
  • Knowledge of CPT-4, HCPCS, Revenue and ICD coding.
  • Expert in Skilled Nursing Managed care plans.
  • Experience in successful operationalizing managed care contracts in the skilled nursing environment.
  • Knowledge of contracts and contractual interpretations for payment and benefit issues.
  • Working knowledge of medical terminology, claims payment, contract negotiations, and problem resolution; ability to work collaboratively in a team setting.
  • Communicate effectively at all organizational levels and in situations requiring instructing, persuading, negotiating, consulting, and advising.
  • Ability to deal with responsibility with confidential matters. Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
  • Strong analytical mind, with problem solving skills, an aptitude for accuracy, and attention to detail.
  • Must be able to prioritize, plan, and handle multiple tasks/demands simultaneously.
  • Excellent verbal and written communication skills, as well as excellent critical thinking skills.
  • Computer savvy (Contract Logix, MS Word, MS Outlook & Excel).
  • Ability to be flexible, be readily adaptable, and work in a rapidly and constantly changing environment.
  • Present in facilities on a weekly basis, (currently as deemed appropriate).

Additional Information:
  • Pre-employment criminal background screening required.

What We Offer:
We are committed to providing a competitive benefits and compensation package which includes medical/dental/vision coverage, company-provided life insurance, 401(k) with company match, and sick/vacation plans. We also believe in supporting our employee's professional growth and development through our Learning Management System as well as training sessions and seminars. Take a look at these benefits (and more!) at www.ensignbenefits.com.
Ensign Services, Inc. is an equal opportunity employer. If you need assistance or accommodation during the application process, please contact us at 888-659-3616.
Job ID 1233

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