- Elevance Health (Miami, FL)
- …providers, claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:** + Requires BA/BS in ... a health-related field and minimum of 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. + Current, unrestricted RN license in applicable state required. + Multi-state licensure is… more
- Elevance Health (Miami, FL)
- …Develop and analyze business performance reports (eg for claims data, provider data, utilization data). + Collect and analyze HR/AR data to create summary statistics ... of performance. + Generate and publish periodic HR/AR reports as well as any necessary ad hoc reports. **Minimum Requirements:** Requires a HS diploma or equivalent; or any combination of education and experience which provides an equivalent background.… more
- Centene Corporation (Tallahassee, FL)
- …reporting with external agencies preferred; Familiarity with claims data, utilization , rate setting, risk adjustment, or member eligibility and reconciliation ... preferred. Pay Range: $26.50 - $47.59 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with… more
- Abbott (Miami, FL)
- …3 complex cases over last 6 months). + Demonstrate ability to increase utilization of Abbott Advanced Mapping and Ablation Tools. + Complete monthly sales activities ... at their Accounts. + Verification that you will satisfy all vendor credentialing requirements, which may include vaccination for COVID-19. If you require a medical or religious accommodation from these requirements or if you would like to understand more about… more
- RTX Corporation (Largo, FL)
- …initiative, perseverance, and creativity in problem solving + Understanding and utilization of business system instruments + A thorough working knowledge of ... Microsoft Office (Word, Excel, and PowerPoint) + The ability to obtain and maintain a US government issued security clearance is required. US citizenship is required, as only US citizens are eligible for a security clearance. **Qualifications We Prefer:** +… more
- Bristol Myers Squibb (Tampa, FL)
- …claim details for accuracy, identifying and documenting rebate payment and utilization variance explanations which may involve communicating with outside parties + ... Processing payments in accordance with established timeframes and in compliance with federal and state government regulations and internal SOX guidelines + Working with contracted third-party dispute resolution coordinator or directly with States or their… more
- Citigroup (Surfside, FL)
- …digital first approach, focus on client problem resolution and effective utilization digital technologies + Resolving complex client issues or needs; connect ... with relevant specialists or senior leaders as needed + Appropriately assesses risk when business decisions are made, demonstrating consideration for the firm's reputation and safeguarding Citigroup, its clients and assets, by driving compliance with… more
- Veterans Affairs, Veterans Health Administration (Sarasota, FL)
- …addressed as medically appropriate. Quality of care should meet professional standards. Utilization of all Virtual Care modalities is an expectation of this ... position. Prescribe medication according to approved formulary, and in accordance with Federal and State Law. Work Schedule: Monday- Friday, 8:00am-4:30pm(Work schedules are determined and approved by the supervisor. The incumbent may be required to work… more
- WM (Naples, FL)
- …that budgets are met; develops and implements programs for optimal equipment utilization , equipment maintenance, and labor and material costs. + Interacts with local ... city, municipal, and county agencies to ensure customer satisfaction, improve efficiency, renew contracts and negotiate new contracts; establishes WM as a good corporate citizen and valued resource. + Ensures District compliance with WM Way processes and… more
- Elevance Health (Miami, FL)
- …documents to convey the determination. + Responsibilities exclude conducting any utilization or medical management review activities which require the interpretation ... of clinical information. + The analyst may serve as a liaison between grievances & appeals and /or medical management, legal, and/or service operations and other internal departments. **Minimum Requirements** + Requires a HS diploma or GED and a minimum of 3… more