- Molina Healthcare (FL)
- **JOB DESCRIPTION** **Job Summary** Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and ... provider training and education, in alignment with Molina Healthcare's... issues that may cross departmental lines and involve Senior Leadership. + Serves as a subject matter expert… more
- Humana (Tallahassee, FL)
- …Contract Requires US Citizenship for this Position. Overview: Join Humana Military's Provider Data Solutions team to support the TRICARE T5 contract and deliver ... work within a caring, collaborative environment. Our team works with large-scale provider data and plays a key role in processing, preparation, dissemination, and… more
- Molina Healthcare (FL)
- **JOB DESCRIPTION** **Job Summary** Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider ... system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts. **KNOWLEDGE/SKILLS/ABILITIES**… more
- AssistRx (Orlando, FL)
- Under the direction of the chief growth officer, the senior manager of provider solutions will lead a high-performing sales team focused on supporting and ... (HCPs). This individual will oversee both the account executives and provider solutions specialists, driving platform adoption and engagement, managing operational… more
- CVS Health (Tallahassee, FL)
- …Summary** + Claims analysis related to disputes, legal matters, state complaints, provider inquiries, and internal team inquires. In order to determine if there ... that may affect Utilization Management, Enrollment, Claims, Configuration, Network, Contracting and/or Provider Data. + If any issues are identified you will submit… more
- Molina Healthcare (Miami, FL)
- …skills to successfully engage high volume, high visibility providers (including senior leaders and physicians) to ensure provider satisfaction, education ... + Initiates, coordinates, and participates in problem-solving meetings between the provider and Molina stakeholders, including senior leadership and physicians.… more
- Molina Healthcare (FL)
- …skills to successfully engage high volume, high visibility providers, including senior leaders and physicians, to ensure provider satisfaction, education ... * Initiates, coordinates and participates in problem-solving meetings between the provider and Molina stakeholders, including senior leadership and physicians.… more
- Humana (Tallahassee, FL)
- …The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral part of the Pricer Business ... the Integrated Network Payment Solutions (INPS) department which falls under the Provider Process and Network Organization (PPNO). The Senior Business… more
- Ascension Health (Gulf Breeze, FL)
- **Details** + **Department:** Multi Provider + **Schedule:** Full time days. Monday-Friday from 7:30-5:00 + **Facility:** Ascension Sacred Heart Medical Group + ... and treatment of patients under the direction of a provider (Physician or Advanced Practice Provider ). +...of care, including more than 140 hospitals and 40 senior living communities in 19 states. Our Mission, Vision… more
- Molina Healthcare (Miami, FL)
- **Job Description** **Job Summary** Responsible for work load assignment to the provider Claims adjudicators and senior provider claims adjudicators. Train ... Provide clear and concise results on the provider claims model across all states. Monitors and controls...to closure. + Perform daily troubleshooting procedures to support Provider Claims functions as needed. + Participates in or… more
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