- Molina Healthcare (Orlando, FL)
- …**Job Summary** Molina's Quality Improvement Sr. Overreader conducts oversight and audits of the data collected and abstracted from medical records for HEDIS ... projects, HEDIS like projects and supplemental data collection. The overreader team will meet chart overread productivity standards, minimum over read standards, and 2nd overread standards to ensure accuracy of their audit skills. Sr. Overread team members… more
- Community Health Systems (Sarasota, FL)
- …The Insurance Verification Supervisor is responsible for assisting the Manager in daily operations of the Benefit Verification team. Assists leadership with ... development of staff and goals of the department. As an Insurance Verification Supervisor at Community Health Systems (CHS) - SSC Sarasota, you'll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality… more
- Sharecare (Tallahassee, FL)
- …Sharecare is the leading digital health company that helps people -- no matter where they are in their health journey -- unify and manage all their health in one ... place. Our comprehensive and data-driven virtual health platform is designed to help people, providers, employers, health plans, government organizations, and communities optimize individual and population-wide well-being by driving positive behavior change.… more
- Sharecare (Tallahassee, FL)
- …Sharecare is the leading digital health company that helps people - no matter where they are in their health journey - unify and manage all their health in one place. ... Our comprehensive and data-driven virtual health platform is designed to help people, providers, employers, health plans, government organizations, and communities optimize individual and population-wide well-being by driving positive behavior change. Driven… more
- Molina Healthcare (Tampa, FL)
- …**Job Summary** Responsible for continuous quality improvements within the Delegation Oversight Department. Oversees delegated activities to ensure compliance ... requirements including delegation standards and requirements contained in the Molina Medical Compliance and Fraud, Waste and Abuse Program. **KNOWLEDGE/SKILLS/ABILITIES** + Coordinates, conducts, and documents delegation assessments as necessary to comply with… more
- AssistRx (Orlando, FL)
- …+ Effectively manage client communications and expectations. + Able to function as subject matter expert in order to collect complete and accurate business ... requirements from clients. + Work as a team player and leader in order to effectively coordinate across functional teams. + Collaborate with Product Management to balance product vision and voice of customer in order to recommend and deliver best-in-class… more
- Insight Global (Juno Beach, FL)
- …Insight Global is looking for a Controls Engineer to join their team for a renewable's clients. This Engineer with be responsible for engineering expertise and ... guidance conceptualizing, interpreting, and executing assignments related to continuous control of energy conversion and storage processes, Plans and develops engineering projects which have important impact on major company programs. Acts as subject matter… more
- Molina Healthcare (Miami, FL)
- …**Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment ... information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings. **KNOWLEDGE/SKILLS/ABILITIES** + Develop ad-hoc reports using SQL programming, SQL Server Reporting Services… more
- Anywhere Real Estate (Jacksonville, FL)
- …This role will collaborate closely with the Anywhere Learning & Development team, Anywhere cross-functional stakeholders, and Brand marketing/GTM teams to develop ... strategic marketing content and execute integrated campaigns that drive awareness, demand, and adoption for our Learning products and services. This highly visible role requires building trust and working closely with key executives, internal teams, and brand… more
- CVS Health (Tallahassee, FL)
- …+ Claims analysis related to disputes, legal matters, state complaints, provider inquiries, and internal team inquires. In order to determine if there are any claim ... payment or denial issues that may affect Utilization Management, Enrollment, Claims, Configuration, Network, Contracting and/or Provider Data. + If any issues are identified you will submit the necessary documents to specific areas to ensure all is updated and… more