- Molina Healthcare (Jacksonville, FL)
- …Ability to influence across multiple organizational functions - Payment Integrity, Claims , Encounters, Finance, and Actuarial + Proven experience in managing complex ... implement efficient enterprise-wide processes and governance structures that span claims , encounters, clinical, finance and actuarial functions. + Identifies,… more
- University of Miami (Miami, FL)
- …compensable events. + Facilitate resolution of complaints/grievances pertaining to quality -of-care issues. + Facilitate interventions as necessary with Patient ... in Root Cause and FMEA analysis as necessary in conjunction with the Quality Team. + Analyze complaint/grievance data and collaborate with Leadership on an Ad… more
- MyFlorida (Fort Pierce, FL)
- …competitiveness, prioritizes Florida's environment and natural resources, and preserves the quality of life and connectedness of the state's communities. Our Vision ... that projects are delivered on time, on budget and meets the department's quality standards. This position directly impacts on the department's ability to deliver… more
- UIC Government Services and the Bowhead Family of Companies (Orlando, FL)
- …products shall meet the customer's requirements, satisfaction, and professional quality standards. **Qualifications** * Bachelor's degree in Art, Art Technology, ... characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq.,...of services which are performed with a focus on quality results. Headquartered in Springfield, VA, we are a… more
- Evolent (Tallahassee, FL)
- …Strategic Accounts, Analytics, Client Finance, Implementation, Clinical Operations, Medical, Quality , and Call Center Teams) to identify new opportunities, deploy ... operational improvement initiatives to improve performance, satisfaction, and clinical quality /outcomes. **Teamwork/Collaboration** - serves as a liaison between the… more
- ChenMed (Greenacres, FL)
- …policies and procedures. Employees model and deliver the highest level of quality healthcare while working directly with patients and their families, doctors and ... receipt; removing outdated drugs. + Maintains knowledge of asset protection techniques, creates claims for order errors and damaged goods. + Maintains a safe and… more
- ChenMed (Greenacres, FL)
- …policies and procedures. Employees models and delivers the highest level of quality healthcare while working directly with patients and their families, doctors and ... receipt; removing outdated drugs. + Maintains knowledge of asset protection techniques, creates claims for order errors and damaged goods. + Maintains a safe and… more
- Molina Healthcare (Tampa, FL)
- …of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of ... Long-Term Services & Supports issues. + Identifies and reports quality of care issues. + Prepares and presents cases...supported by the plan such as Utilization Review, Medical Claims Review, Long Term Service and Support, or other… more
- UIC Government Services and the Bowhead Family of Companies (Jacksonville, FL)
- …and other protected characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq., and federal contractual ... based on the provisions contained within The Alaska Native Claims Settlement Act. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities. All… more
- Humana (Tallahassee, FL)
- …closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid ... Creating and executing comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance, and compliance + Determining root causes driving issues and… more