- Stantec (Orlando, FL)
- …and forecasting. - Experience with scheduling large, complex projects. - Experience with claims management for design projects. - Sound knowledge and experience ... projects as if they were our own, our project management business, and technical experts work with clients to...Claims /Risk mitigation. - Oversee and approve development and management of the Project Scope WBS. - Oversee and… more
- AdventHealth (Altamonte Springs, FL)
- …the Physician Advisor is responsible for providing clinical review of utilization, claims management , and quality assurance related to inpatient care, outpatient ... you will contribute:** The Physician Advisor provides primary support for Utilization Management (UM) and secondary support for Care Management (CM) departments… more
- LEGOLAND (Winter Haven, FL)
- …to the system as new information is received in regards to guest/employee incidents and claims management . + Follows up on the status of all General Liability, ... Bodily Injury, Property Damage and Auto claims with insurance companies and TPA claims administrators as needed. + Forwards all telephone and written… more
- AdventHealth (Maitland, FL)
- …all provider types Managed Care, Patient Financial services, health insurance claims processing, contract management , or medical economics experience Proficiency ... sources using knowledge of healthcare managed care contracts and healthcare administrative claims data Reviews existing complex models and implements them on new… more
- RELX INC (Boca Raton, FL)
- …as necessary Requirements + Have proven experience in leave administration, including with Claims Management . + Have an exceptional attention to detail + Be ... including counseling employees on leave applications and ensuring timely adjudication of claims by the Third Party Administrator (TPA) + Entering leave data into… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …matter expertise, as well as knowledge of the interconnection between Utilization Management , claims , and regulatory requirements to respond to complex and/or ... + Reviews cases referred by the prior-authorization non-clinical medical management coordinator and pre-certification technician staff according to member benefits,… more
- Molina Healthcare (FL)
- …of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management , Network, and other departments to enable critical ... + Knowledge of healthcare operations (utilization management , disease management , HEDIS quality measures, claims processing, etc.) + Knowledge of… more
- Molina Healthcare (FL)
- …of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management , Network, and other departments to enable critical ... sources. + Knowledge of healthcare operations (utilization management , disease management , HEDIS quality measures, claims processing, etc.) + Knowledge of… more
- The Cigna Group (Fort Lauderdale, FL)
- …of communication with matrix partners including but not limited to, Claims Operations, Medical Management . Credentialing, Legal, Medical Economics, Compliance, ... 3 days per week The **Manager, Provider Contracting Network Management ** serves as an integral member of the Provider...This role assists in developing the strategic direction and management of the day to day contracting and network… more
- HCA Healthcare (Atlantis, FL)
- …operation of the clinical risk and patient safety program on a day-to-day basis and claims management program and risk management education for the facility. ... exposure. Responsible for coordinating activities that focus on the management of claims and pretrial preparation. Also responsible for the grievance process… more