- Humana (Tallahassee, FL)
- …be required to work in either Central or Eastern Time. Associate Director, Regulatory Intake Compliance is responsible for enterprise-wide regulatory ... risk exposure for the organization. The Associate Director, Regulatory Intake Compliance will be responsible for/to:...years of management experience + Advanced experience working in compliance , risk management, or managed -care field +… more
- Molina Healthcare (Miami, FL)
- …review. The position may also work with other internal departments, including Compliance , Corporate Legal Counsel, and Medical Officers in order to achieve and ... various internal customers (eg, Provider Services, Contracting and Credentialing, Healthcare Services, Member Services, Claims) to gather documentation pertinent to… more
- Highmark Health (Tallahassee, FL)
- …healthcare operations, risk, audit, or legal functions + 5 years in Healthcare Compliance or Privacy **LICENSES or CERTIFICATIONS** **Required** + None ... rules as well as a solid working knowledge of managed care operations, compliance program structures, information...(CIA) + Certified Fraud Examiner (CFE) + Certified in Healthcare Compliance (CHC) + Certified Compliance… more
- Molina Healthcare (Miami, FL)
- …Degree in Healthcare Administration **Preferred Experience** + 10 years of managed care experience ( Regulatory and Compliance ) + Previous management ... Administration such as oversight, audit, etc. **Required Experience** * 7 years of managed care experience ( Regulatory and Compliance ) * Previous management… more
- Molina Healthcare (FL)
- …network development and management, or project management experience in a managed healthcare setting. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : ... in a managed care setting. * Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare… more
- Molina Healthcare (St. Petersburg, FL)
- …Participate in process improvement initiatives to improve operations + Understands the compliance and regulatory guidelines for each state + Maintains ... coaching, production and appropriate terminations. + Ensures staff is compliant with regulatory and company guidelines, including HIPAA compliance . + Responsible… more
- Molina Healthcare (Miami, FL)
- …dynamics, and the latest Medicaid trends, positioning Molina as a leader in Medicaid managed care + Track regulatory compliance and address any operational ... and experience + 7 years in market strategy, business development, or healthcare consulting, specifically within Medicaid managed care or equivalent related… more
- Iron Mountain (Tallahassee, FL)
- …preferred. + Strong understanding of healthcare data standards, interoperability, and regulatory compliance (eg, HIPAA, GDPR). + Proven ability to define and ... to improve patient care and reshape how information is managed and delivered in a clinical setting? Iron Mountain...Leverage your deep understanding of EHRs, the exchange of healthcare information, regulatory requirements (eg, HIPAA), and… more
- Molina Healthcare (St. Petersburg, FL)
- …environment. * 3+ years experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, ... group and hospital contracting, etc. * Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and… more
- Molina Healthcare (FL)
- …management experience. + 3+ years supervisory experience in a managed healthcare environment. **Preferred License, Certification, Association** Active, ... non-clinical team activities to facilitate integrated, proactive utilization management, ensuring compliance with regulatory and accrediting standards. + Manages… more
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