- Molina Healthcare (FL)
- **Job Description** **Job Summary** The Health Plan Operations , Payment Integrity Program Manager is an individual contributor role designed for a highly ... capable individual who serves as a key strategic partner in driving health plan financial performance. This role focuses on identifying, leading, and executing… more
- Centene Corporation (Tallahassee, FL)
- …preferred. + 10+ years management experience 10+ years of experience in communications, health plan operations and strategy, change management, project ... Centene is transforming the health of our communities one person at a...focused on the execution of key performance indicators (KPIs). Plan , track, and monitor the progress of key priorities… more
- Healthfirst (FL)
- …+ Bachelors degree from an accredited institution + Experience in Healthcare/ Health Plan customer service, operations , vendor management, ... on trending audit finding results and summarizing details to Operations leadership to address identified areas for improvement. +...lines of business such as Medicare NY/NJ, Medicaid, Family Health Plus, Child Health Plus, NH Family… more
- Highmark Health (Tallahassee, FL)
- …and Provider support teams, Actuary, Finance, Highmark Health Solutions, Health Plan Operations . **ESSENTIAL RESPONSIBILITIES** + Perform management ... business. This will require aligning new models to the health plan 's strategic objectives based on a...Plan , organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and… more
- Elevance Health (Miami, FL)
- …overturn primary decision. + Works with various departments including Provider Solutions and Health Plan Operations leadership when necessary, to determine ... root cause and appropriate resolution. + Must work with Claims Operations to remediate impacted claims. **Minimum Requirements:** + Requires a HS diploma or GED and… more
- Convey Health Solutions (Fort Lauderdale, FL)
- …school diploma required; Associates Degree or higher preferred + Minimum 2 years Health Plan Operations experience including; Enrollment (preferred), Claims ... the needs of government-sponsored health plans. OUR MISSION To improve health plan operations and elevate the customer experience. OUR VISION Empowering … more
- Convey Health Solutions (Fort Lauderdale, FL)
- …meet the needs of government-sponsored health plans. OUR MISSION To improve health plan operations and elevate the customer experience. OUR VISION ... PowerPoint, and Outlook. About Us WHO WE ARE Convey Health Solutions manages a myriad of administrative needs and...myriad of administrative needs and make it easier for health plans to operate and provide valuable experiences for… more
- Molina Healthcare (St. Petersburg, FL)
- …point of contact for the internal partners, ie Medicare Administration, Compliance and Health Plan Operations . Coordinates and facilitates meetings providing ... processing and maintenance of new members and re-enrollment. Processes and maintains health plan 's member and enrollment records, employer's monthly reports,… more
- Evolent (Tallahassee, FL)
- …transformative growth opportunities at customer accounts + Strong knowledge of health plan operations , care/utilization management, claims processing, ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health … more
- Molina Healthcare (Miami, FL)
- …Experience** * Min. 5 years operations or administrative experience in healthcare/ health plan industry, including 1+ years as a supervisor. * Strong ... Degree **Preferred Experience** 3+ years of healthcare or health plan supervisory experience. Managed Care operations experience. Prior Medical Assistant… more