- ChenMed (Miami, FL)
- …the primary medical cost analytics consultant to our Finance, Clinical, Operations , and Specialty Care leadership and will make data-driven strategy recommendations ... **ESSENTIAL JOB DUTIES/RESPONSIBILITIES:** + Analyzes and interpret enrollment, revenue, and claims (utilization and unit cost) data to identify and solve business… more
- Molina Healthcare (Jacksonville, FL)
- … operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) + Knowledge of healthcare financial terms (eg, PMPM, ... executive decision-making + Mine and manage information from large data sources. + Analyze claims and other data sources to identify early signs of trends or other… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- …regulatory team (GRL, regional leads, CMC-RA, labeling, medical writing, regulatory operations , etc.) to develop global regulatory plans, address global regulatory ... you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to...legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,… more
- Evolent (Tallahassee, FL)
- …offers candidates the opportunity to positively impact member's care daily. Our clinical operations team possess a can-do spirit, as they will wear multiple hats ... and serves in a supporting role to the Director, Intake and Utilization Management Operations . + This individual will not only lead a production team but will also… more
- Prime Therapeutics (Tallahassee, FL)
- …the technical and leadership skills that ensure successful Part D pharmacy operations and program compliance within the pharmacy business unit. Makes business ... D eligibility requirements, Part D plan designs, drug formularies, drug pricing, claims processing and reimbursements, True Out of Pocket expenditures, that ensure… more
- MyFlorida (Ocoee, FL)
- …for providing legal representation in defense of the Department in claims of inverse condemnation, as assigned. Responsible for thoroughly researching all ... and federal statutes, court cases, rules, and regulations affecting the operations of the Turnpike Enterprise. Responsible for advising Turnpike Enterprise program… more
- Doosan Bobcat (Miami Lakes, FL)
- …of customer issues. This position also works closely with the Operations , distribution, logistics and compliance on improvements and decision making regarding ... export, and process related issue resolution in regards to shipping, documentation, claims , lead times and customer service. Acting as the main liaison between… more
- Bristol Myers Squibb (Tampa, FL)
- …In this position, you will play a key role within the Medicaid Rebate Operations team, which manages the intake, processing, and payment of multiple labeler codes ... Act as subject matter expert related to Model N claims & payment processing and reporting functionality and has...BMS Model N IT Support teams and Government Contract Operations team. **Responsibilities:** + Analyzing invoices and claim details… more
- L3Harris (Melbourne, FL)
- …risk assessment and oversight of personal injury, property damage and WC claims ; + Coordinate with Risk Management and other stakeholders to maximize recovery ... of legal fees, costs and judgments for covered claims . + As needed, lead or support internal and...VP with several aspects of department management including legal operations , policy reviews and updates, development of standard work,… more
- Amentum (Tallahassee, FL)
- …of insurance placements and risk mitigation strategies aligned with the company's operations and strategic objectives. The Director acts as a key advisor to ... appropriate insurance coverage and risk mitigation strategies. + Lead complex claims management, including litigation strategy and resolution in coordination with… more