- 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
- Humana (Tallahassee, FL)
- …Professional at Humana, you will play a pivotal role in enhancing provider performance and advancing Humana's mission to deliver high-quality healthcare. You will ... Senior Healthcare Network Consultant /Senior Network Performance Professional + ** Provider Collaboration** : Work with providers to define and advance… 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
- Elevance Health (FL)
- …The **Reimburse Implement Specialist II** provides accurate, timely maintenance of complex provider and reimbursement information. **How you will make an impact:** + ... Synchronizes data on claims and provider databases and provides expertise on business requirements for multiple business regions. + Identifies, analyzes, and… more
- Bluestone Physician Services (Tampa, FL)
- …social determinants of health, manage transitions to and from inpatient settings, provide behavioral health support and more. Under our model of care, Bluestone ... organizer for the operational execution and integration of Primary Care functions. Provider Resourcing + Tracking assignment of providers to communities + Presenting… more
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