- Elevance Health (Tampa, FL)
- ** Clinical Provider Auditor II** **Supports the Payment Integrity line of business** **Hybrid 1** : This role requires associates to be in-office **1-2** days ... is determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** Clinical Provider Auditor II** is responsible for identifying issues… more
- Evolent (Tallahassee, FL)
- …care in value-based care frameworks, and thrives at the intersection of clinical quality, operations, and strategic provider collaboration. This leadership role ... the development and execution of innovative engagement opportunities such as regional clinical symposiums and local provider experience advisory panels + Own… more
- LogixHealth (Dania Beach, FL)
- …to providing expert revenue cycle services, we utilize proprietary software to provide valuable financial, clinical , and other data insights that directly ... On-Site in Dania Beach, FL This Role: As a Provider Enrollment Specialist at LogixHealth, you will perform all...+ Revenue cycle knowledge About LogixHealth: At LogixHealth we provide expert coding and billing services that allow physicians… more
- Centene Corporation (New Port Richey, FL)
- …Purpose:** Maintain partnerships between the health plan and the contracted provider networks serving our communities. Build client relations to ensure delivery ... act as a liaison between the providers and the health plan + Triages provider issues as needed and coordinates response with internal matrix partners + Receive and… more
- The Cigna Group (Tampa, FL)
- …improve total medical cost and quality. + Drives change with external provider partners by assessing clinical informatics and offering consultative expertise ... to work in the office or visit Providers 3 days per week The **Manager, Provider Contracting Network Management** serves as an integral member of the Provider … more
- Elevance Health (Tampa, FL)
- …for all network management functions within the specified region. + Develops provider networks that provide a competitive advantage. + Align contracting ... companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive… more
- Humana (Niceville, FL)
- …of our caring community and help us put health first** The Provider Engagement Professional 2 develops and grows positive, long-term relationships with physicians, ... within the contracted working relationship with the health plan. The Provider Engagement Professional 2 work assignments are varied and frequently require… more
- Molina Healthcare (Miami, FL)
- **JOB DESCRIPTION** **Job Summary** Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and ... provider training and education, in alignment with Molina Healthcare's...Molina policies/procedures or CMS guidelines/regulations, or to assess the non- clinical quality of customer service provided to Molina members.… more
- Molina Healthcare (FL)
- **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and provider ... plan and in compliance with all relevant federal, state and local regulations. Provider Relations staff are the primary point of contact between Molina Healthcare… more
- Centene Corporation (Orlando, FL)
- …Purpose:** Maintain partnerships between the health plan and the contracted provider networks serving our communities. Build client relations to ensure delivery ... act as a liaison between the providers and the health plan + Triages provider issues as needed for resolution to internal partners + Receive and effectively respond… more