- Wells Fargo (Miami, FL)
- …+ Ability to interact and collaborate with individuals across departments. + Experience with claims research and management + Cash Management or Armored ... our focus on building strong customer relationships balanced with a strong risk mitigating and compliance -driven culture which firmly establishes those… more
- CDM Smith (Fort Myers, FL)
- …project team in developing and maintaining a project risk register. Claim management : Early support for claims and disputes on the project. Identify ... clauses. Support provided to the project teams on contract compliance for key projects, as well as managing and...including management and tracking of such correspondence. Risk Management : Support the project teams in… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- …standards and implementing procedures to ensure that the business units quality management and compliance program are effective and efficient in identifying, ... implements, and maintains policies, systems and procedures describing internal processes for management of quality and compliance with applicable regulations and… more
- AdventHealth (Maitland, FL)
- … claims analytics Managed Care, Patient Financial services, health insurance claims processing, contract management , or medical economics Proficiency in ... contracts and proposals, analyze fee schedules, and determine contract compliance . The Senior Medical Economics analyst must have attention...understanding professional and facility claims and managed care concepts such as … more
- Molina Healthcare (Jacksonville, FL)
- …the organizational health care costs for all lines of business and directly impacting Risk Revenue and Quality Compliance . Partner with VP Encounter to ensure ... **Job Description** **Job Summary** The AVP, Risk Adjustment Encounters is responsible for establishing enterprise-wide strategy, governance, and oversight of… more
- Molina Healthcare (St. Petersburg, FL)
- **Job** ** ** **Summary** Safeguard member trust and plan compliance by owning Molina's entire CMS Complaints Tracking Module (CTM) life cycle. As Director of CTM ... you keep complaint data synchronized across appeals & grievances, enrollment, claims , pharmacy, and quality functions. You surface systemic issues, steer partners… more
- AIG (Miami, FL)
- …and distribution. + Interact with different areas of the Company such as Claims , Legal, Compliance , Actuarial, Finance, and Accounting among others for the ... We are reimagining how we help customers to manage risk , transforming our operating model, and reshaping our role...the regional underwriting strategy and the day-to-day underwriting, and management of the LATAM Political Violence and Cyber White… more
- Evolent (Tallahassee, FL)
- …primarily focused on performing medical economics analysis in support of complex risk -based contract development and will partner with stakeholders of various levels ... across analytics, finance, and account management . **What You Will Be Doing:** + Develop and...presentations. + Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data to make recommendations based… more
- Orlando Utilities Commission (Orlando, FL)
- …testing and all other compliance related filings. + Partner with risk management on Worker's Compensation processes, including navigating employee injuries ... program enrollments, terminations, changes, beneficiaries, disability, accident and death claims , rollovers, distributions, loans, hardships and compliance … more
- MyFlorida (Tallahassee, FL)
- …above. Postsecondary education in the field(s) of criminology, healthcare administration, accounting, risk management , or similar discipline may be used as an ... our E-Verify Website (http://www.dms.myflorida.com/workforce\_operations/human\_resource\_management/for\_job\_applicants/e\_verify) . Requisition No: 859230 Agency: Management Services Working Title: HEALTH INSURANCE FRAUD ANALYST II… more