- Healthfirst (FL)
- …Qualifications** + Demonstrated experience or deep understanding of healthcare Operations processes and supporting systems such as Claims Processing, ... + Experience in Healthcare /Health Plan customer service, operations , vendor management, or claims processing. +...Demonstrated experience or deep understanding of healthcare Operations processes and supporting systems such as Claims… more
- Evolent (Tallahassee, FL)
- …**What You Will Be Doing:** + **Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, ... working seamlessly with diverse teams and stakeholders. + Familiarity with healthcare claims , reimbursement methodologies, and cost/utilization KPIs, including… more
- Molina Healthcare (Orlando, FL)
- …managed care experience + Experience in one or more of the following: Claims , Provider Services, Provider Network Operations , Hospital or Physician Billing, or ... and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system… more
- Molina Healthcare (St. Petersburg, FL)
- …The Subrogation Manager is responsible for overseeing all aspects of healthcare subrogation operations across Medicaid, Medicare, and Marketplace lines ... across a wide range of subrogation case types-including automobile-related claims (eg, no-fault/PIP), workers' compensation, general liability, medical malpractice,… more
- Molina Healthcare (FL)
- …and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system ... provider-related data and reports in support of Network Management and Operations areas of responsibility (eg, Provider Services/Provider Inquiry Research &… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- **Position Summary** The Senior Manager, Fleet & Samples Operations oversees the execution of field fleet logistics and pharmaceutical sample distribution. The role ... reliability, and compliance while collaborating closely with the Field Strategy & Operations team to meet field force needs. **Key Responsibilities** **Fleet … more
- Kyndryl (Tallahassee, FL)
- …Contact Center operations for enterprise organizations, particularly those in the Healthcare or State or Local Government and / or Educational (SLED) spaces. ... innovative solutions that enhance customer journeys, improving customer technology operations , and integrate cutting-edge capabilities such as Agentic AI. The… more
- Molina Healthcare (FL)
- …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 overall mission, core values, and strategic plan and...3 - 5 years customer service, provider service, or claims experience in a managed care setting. + 3-5… more
- Molina Healthcare (Miami, FL)
- …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 overall mission, core values, and strategic plan and...2 - 3 years customer service, provider service, or claims experience in a managed care setting. + Working… more
- The Cigna Group (Tampa, FL)
- …of communication with matrix partners including but not limited to, Claims Operations , Medical Management. Credentialing, Legal, Medical Economics, Compliance, ... or complex provider contracts and alternate contract terms. + Creates healthcare provider agreements that meet internal operational standards and external provider… more