- Molina Healthcare (FL)
- …or team leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment + Strong knowledge of SQL ... including expected and actual revenues/volumes, past performance, proposed contract language, risk adjustment and regulatory changes To all current Molina employees:… more
- Humana (Fort Lauderdale, FL)
- …safeguarding Humana's data and technology assets. The team manages cybersecurity, risk management, and regulatory compliance through advanced technologies and best ... core insurance operations by developing and maintaining systems for claims processing, underwriting, policy administration, and member enrollment. Projects often… more
- Molina Healthcare (FL)
- …setting. **Required Experience** + 3 - 5 years customer service, provider service, or claims experience in a managed care setting. + 3-5 years' experience in managed ... but not limited to; fee-for service, capitation, and various forms of risk , ASO, etc. **Preferred Education** Bachelor's or master's degree. **Preferred Experience**… more
- USAA (Tampa, FL)
- …reserving model that considers all available information of the event, exposures, and claims at the time of the event and continuously refreshes the estimates with ... are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures. **What you have:** + Bachelor's… more
- Molina Healthcare (Miami, FL)
- …Molina Healthcare provider network consists of providers that meet all regulatory and risk management criteria to minimize liability to the company and to maximize ... credentialing database necessary for processing of recredentialing applications. * Reviews claims payment systems to determine provider status, as necessary. *… more
- Mass Markets (FL)
- …records, and a comprehensive system of controls and budgets designed to mitigate risk , enhance the accuracy of the company's reported financial results, and ensure ... 736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing, Collections, Customer Experience Provider (CXP), Customer Service,… more
- Centene Corporation (Tallahassee, FL)
- …business needs. + **Design and maintain** attribution models based on claims data, member selection, contractual arrangements, and regulatory requirements. + ... policy changes. + **Support strategic initiatives** related to value-based care, risk adjustment, and quality improvement by ensuring attribution integrity. +… more
- Republic Finance, LLC (Tampa, FL)
- …the success of the branch, including evaluating loan applications, performing risk analysis, making credit decisions, administering loan closings, and processing ... insurance claims . Your management abilities shine as you assist the Branch Manager with recruiting and training as well as developing and implementing plans to meet… more
- WTW (Miami, FL)
- …teams of consultants across WTW, including brokers, service colleagues, and claims advocates, to deliver efficient and effective support. This role requires ... strategic planning and consulting advice to clients, monitoring insurance and risk management needs in collaboration with WTW resources, practice, and industry… more
- NextEra Energy (Juno Beach, FL)
- …hearings, and appeals across multiple jurisdictions + Oversee inverse condemnation claims and property damage disputes + Manage appeals and complex valuation ... internal teams on land acquisition strategies, easement negotiations, and risk mitigation. **_Stakeholder Relations_** + Build relationships with landowners,… more