- Humana (Tallahassee, FL)
- …for IHWA is responsible for overseeing and advancing key initiatives that drive organic provider capture following an IHWA visit. This position plays a vital role in ... Key responsibilities include monitoring program activities, leading efforts to optimize provider participation, and applying expertise in causal analysis and … more
- Humana (Dunedin, FL)
- …us put health first** This role is currently remote with travel to provider offices within region The Quality Improvement Senior Clinical Professional (RN) is ... Improvement, Clinical Professional (RN)) represents the scope of health plan/ provider relationships across the following areas: + Provider...Please be aware that applicants may be asked to provide their Social Security Number, if it is not… more
- Centene Corporation (Tallahassee, FL)
- …Continental United States. **Position Purpose:** Responsible for developing and managing the provider network strategy for Centene Corporation. Lead all aspects of ... provider network strategy including, but not limited to reimbursement...networks from a cost, coverage, and growth perspective. + Provide leadership in evaluating opportunities to expand or change… more
- Humana (Gainesville, FL)
- …caring community and help us put health first** This is a hybrid position- requires onsite provider visits up to 40% of the time and is not fully remote. The Senior ... the plan quality. + Medical records reviews, EMR remote provider gap closure support will be 30% of role...age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our… more
- Humana (Tallahassee, FL)
- …cost efficiency, and population health outcomes through strategic provider partnerships, data-informed decision-making, and cross-functional collaboration. The RVP ... mission and Medicare Advantage goals. **Primary Responsibilities:** Clinical Engagement & Provider Strategy: + Cultivate and maintain trusted relationships with CMOs… more
- Humana (Tallahassee, FL)
- …relationships with dental providers, manages the contracting process, and supports provider onboarding to enhance member access to dental care. Responsibilities of ... federal Medicaid guidelines. + Collaborate with internal teams (legal, credentialing, provider relations) to support a smooth onboarding experience for new… more
- Highmark Health (Tallahassee, FL)
- …realization. Critical partners include Advanced Analytics, Contracting, Market and Provider support teams, Actuary, Finance, Highmark Health Solutions, Health Plan ... based on data and market research. Working closely with Contracting and Provider Relation Leaders and others across the enterprise to develop targeted reimbursement… more
- Community Health Systems (Naples, FL)
- …line teams, and outreach staff to enhance access to care, promote provider engagement, and address barriers to satisfaction. Through strategic outreach and ... and track progress. + Develops and manages outreach activity plans, provider targeting strategies, and KPI tracking in alignment with market objectives.… more
- University of Miami (Miami, FL)
- … Provider Skills Assessment Summary Template. Consultation Services: + Provide consultation services to enrollees, offering guidance and support related to ... Psychiatry has been contracted by the Florida Department of Health to provide behavioral health and psychiatric consultation services to selected pediatric primary… more
- CHS (Clearwater, FL)
- **Overview** **Insurance Call Center Supervisor** **Member and Provider Services Supervisor (Insurance)** + **Monthly metric bonuses based on performance!** + **No ... marketing organizations, and employers. One such service is Member and Provider Services, where inbound calls, outbound calls and correspondence from members… more