- Humana (Tallahassee, FL)
- …first** The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex ... approved ABMS Medical Specialty + **A current and unrestricted license in KY or willing to obtain by start...to obtain by start date. Willingness to obtain additional license (s), as required, but not limited to IN, OH,… more
- Centene Corporation (Tallahassee, FL)
- …to providers that would improve utilization and health care quality. + Reviews claims involving complex, controversial, or unusual or new services in order to ... treating or managing care for a culturally diverse population preferred. ** License /Certifications:** Board certification in a medical specialty recognized by the… more
- CDM Smith (Sarasota, FL)
- …management activities, including critical path method (CPM), scheduling and claims administration. Interprets plans and specifications for clients, contractors, and ... candidate will be required to work 100% in the field locations. **Driver's License Requirements:** An appropriate and valid driver's license is required.… more
- World Insurance Associates, LLC. (Miami, FL)
- …resolving day-to-day customer inquiries and escalate issues related to eligibility and member claims + Develop and leverage knowledge of customer needs and issues to ... customer service skills as well as sales negotiation skills. + Life & Health License (preferred) + Must be proficient with MS Office: Word, Excel, and PowerPoint +… more
- Elevance Health (Tampa, FL)
- …rates of reimbursement, as applicable. Assists in problem solving with providers, claims or service issues **Minimum Requirements:** + Requires BA/BS in a health ... experience, which would provide an equivalent background. + Current, unrestricted RN license in applicable state(s) required. + Multi-state licensure is required if… more
- Molina Healthcare (Tampa, FL)
- …medical management, network contracting and provider relations, member services, claims management, payment integrity, pharmacy, quality and risk adjustment. * ... * Active and unrestricted Doctor of Medicine (MD) or Doctor of Osteopathy (DO). License must be active and restricted in state of practice. * Board certification. *… more
- Evolent (Tallahassee, FL)
- …+ Participates in continuing education initiatives. + Collaborates with Claims , Quality Management and Provider Relations Departments as requested. + ... + Registered Nurse or Licensed Practical/Vocational Nurse with a current, unrestricted license . + High School Diploma or equivalent required + Minimum of three… more
- Elevance Health (Tampa, FL)
- …reimbursement, as applicable. + Assists in problem solving with providers, claims or service issues. Assists with development of utilization/care management policies ... experience, which would provide an equivalent background. + Current unrestricted RN license in applicable state(s) required. + Multi-state licensure is required if… more
- Voltyx (Sanford, FL)
- …for extended periods, able to lift 70 lbs. + Must have a valid driver's license and currently have and be able to maintain a good driving record. **Preferred:** + ... recruiters or third-party recruiting agencies, and will not recognize claims to any unsolicited resumes or candidate information.** \#WEEMPOWERPOSSIBLE… more
- Walmart (Wesley Chapel, FL)
- …Center in accordance with Company policies and procedures by properly handling claims and returns, zoning the area, arranging and organizing merchandise, and ... are listed, there are no minimum qualifications._ Minimum QualificationsValid state-issued driver's license . I acknowledge that the position for which I am applying… more