- Molina Healthcare (St. Petersburg, FL)
- …operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) + Knowledge of healthcare financial terms (eg, PMPM, ... related to cost, utilization and revenue for multiple Molina Healthcare products. Analyzes data and dashboard reports to monitor...and manage information from large data sources. + Analyze claims and other data sources to identify early signs… more
- Molina Healthcare (Jacksonville, FL)
- …operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) + Knowledge of healthcare financial terms (eg, PMPM, ... related to cost, utilization and revenue for multiple Molina Healthcare products. Designs and develops reports to monitor health...and manage information from large data sources. + Analyze claims and other data sources to identify early signs… more
- Molina Healthcare (Orlando, FL)
- …Provider Network Operations, Hospital or Physician Billing, or similar. + Claims processing background including coordination of benefits, subrogation, and/or ... and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …and credentialing documents are entered and/or scanned into the Doctors HealthCare Plans, Inc, ("DHCP") credentialing CACTUS database, provide data entry and ... Department. This position will assist the Credentialing Department in the timely processing of Initial Credentialing / Recredentialing of application, processing … more
- Molina Healthcare (Jacksonville, FL)
- …of encounters as well as provides leadership support at managing overall healthcare costs. + Ability to influence across multiple organizational functions - Payment ... Integrity, Claims , Encounters, Finance, and Actuarial + Proven experience in...staff and implements processes to standardize the overall ends-to-end processing , management and accuracy of encounters, as well as… more
- Molina Healthcare (Orlando, FL)
- …deliver analytics and reporting solutions that help track, measure, and optimize automated claims processing solutions. The role will leverage tools like Power ... reporting to track solution effectiveness and surface potential issues + Creating claims impact reporting to assess automation potential, issues or financial impact… more
- Molina Healthcare (Jacksonville, FL)
- …optimize data models to support analytical and operational use cases, including healthcare claims and utilization data. * Collaborate with cross-functional ... HEOR (Health Economics and outcomes Research) * Prior experience working in the healthcare industry with familiarity in clinical, claims , or care management… more
- Molina Healthcare (St. Petersburg, FL)
- …in Medicaid, Medicare, and Marketplace lines of business. + Familiarity with QNXT claims processing platform. + Knowledge of legal procedures related to complex ... The Subrogation Manager is responsible for overseeing all aspects of healthcare subrogation operations across Medicaid, Medicare, and Marketplace lines of business.… more
- HCA Healthcare (Niceville, FL)
- …illnesses. Prepares and conducts ongoing health inservices. Ensures the timely processing of employee workers' compensation claims ; evaluates occurrence reports ... Hospital our nurses set us apart from any other healthcare provider. We are seeking a(an) RN Infection Prevention...RN Infection Prevention and Employee Health to join our healthcare family. **Benefits** HCA Florida Twin Cities Hospital, offers… more
- Molina Healthcare (Miami, FL)
- …applicants. * Completes data corrections in the credentialing database necessary for processing of recredentialing applications. * Reviews claims payment systems ... DESCRIPTION** **Job Summary** Molina's Credentialing function ensures that the Molina Healthcare provider network consists of providers that meet all regulatory and… more