- Molina Healthcare (Tampa, FL)
- …and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure a ... disease management , and evidence-based guidelines. + Experience in Utilization/Quality Program management + HMO/Managed care experience **PR** **E** **FE**… more
- Citigroup (Tampa, FL)
- …such as the implementation of new Compliance systems, controls, and related project management work efforts. + Assisting in the development and administration of ... Personal Banking Operations - Core Operations Independent Compliance Risk Management (ICRM) responsible for establishing internal strategies, policies, procedures,… more
- CVS Health (Tallahassee, FL)
- …Operations - Claims , Plan Build, Eligibility, Appeals, Compliance and Client Management , to ensure quality considerations are integrated into all aspects of the ... + Ensures regulatory compliance. + Collaborate with cross-functional teams, including Client Management , Local Market Development , IT and others to drive a… more
- Molina Healthcare (FL)
- …and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure a ... management , and evidence-based guidelines. + Experience in Utilization/Quality Program management + HMO/Managed care experience **PREFERRED LICENSE,… more
- LEGOLAND (Winter Haven, FL)
- …best practices. + Act as the **primary contact for General Liability (GL) claims ** , ensuring efficient case management , documentation, and legal coordination. ... Action Plan, and key business priorities** , ensuring continuous improvement in risk management . By embedding **health and safety as a core value** , this position… more
- CVS Health (Tallahassee, FL)
- …healthcare journeys for health plan members. A strong understanding of health insurance claims data is required. This role will build and utilize algorithms to ... years of relevant healthcare analytics work experience + Experience with health insurance claims data analytics + Strong knoweldge of SQL + Strong knoweldge of… more
- Kemper (Miami, FL)
- …every day. We believe a high-performing culture, valuable opportunities for personal development and professional challenge, and a healthy work-life balance can be ... assigned cases. + Aggressively pursues files referred to Staff Counsel by the Claims Department. + Creates and maintains a documented strategy for case handling in… more
- Kemper (Miami, FL)
- …every day. We believe a high-performing culture, valuable opportunities for personal development and professional challenge, and a healthy work-life balance can be ... on assigned cases Aggressively pursues files referred to Staff Counsel by the Claims Department. + Creates and maintains a documented strategy for case handling in… more
- Kemper (Tampa, FL)
- …every day. We believe a high-performing culture, valuable opportunities for personal development and professional challenge, and a healthy work-life balance can be ... collaborating with peers in the sales organization, State Product Managers, Claims , Agency Support and Licensing, Marketing, and Customer Service/Underwriting. + The… more
- Mass Markets (FL)
- …Temporary and Administrative Professional Staffing (TAPS Schedule 736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing, ... (CXP), Customer Service, Digital Experience Provider (DXP), Account Receivables Management (ARM), Application Software Development , Managed Services, and… more
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