- Elevance Health (Miami, FL)
- ** Provider Contract / Cost of Care Analyst Senior-Analytics** **Location:** This position will work a hybrid model (remote and office). Must live within 50 ... dives to uncover root-cause trend drivers and support initiative design for remediation. The ** Provider Contract / Cost of Care Analyst Senior** provides… more
- Elevance Health (Miami, FL)
- **Value Based Contract / Cost of Care ...will be responsible for providing analytical support to the Cost of Care and/or Provider Contracting ... Consultant** The **Value Based Contract / Cost of Care Consultant** will focus on...provider negotiations. + Analyzes claims experience to identify cost of care initiative opportunities. + Measuring… more
- University of Miami (Hialeah, FL)
- …issues. + Measures and monitors contract compliance, supplier performance per contract , service level agreements, and realized cost savings. + Partners with ... please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Sr. Manager, Contract The University of Miami/UHealth Department of Supply Chain… more
- CDM Smith (Miami, FL)
- …County Department of Transportation and Public Works has awarded our team the contract to provide Construction Engineering and Inspection services for the new ... contractor's submittals for completeness, accuracy, and compliance with construction contract documents. Drafting documents for possible construction contract … more
- Elevance Health (Miami, FL)
- … provider network by managing the implementation of strategies for provider recruitment, contract negotiations, and relationship development for large health ... ** Provider Network Management Director** **Location:** This position will...health systems, affiliated providers and supports value based and cost of care initiatives. **How you will… more
- MyFlorida (Fort Lauderdale, FL)
- …of claims and provider reimbursement issues/complaints to determine managed care plan compliance with contract provisions. Coordinates and performs ... focused on advancing Governor DeSantis' vision for Florida's health care system to be the most cost -effective,...managed care plans related to compliance with contract provisions, provider reimbursement and claims processing… more
- Boys Town (Pompano Beach, FL)
- …on certain maintenance drugs. Boys Town takes your mental health seriously with no cost mental health visits to an in-network provider . We help our employees ... associated with the families. + Assesses problems and provides care to youth and families; monitors individual and family...regular review and update of service plans. + May provide outreach and prevention services to include increasing community… more
- HCA Healthcare (Sunrise, FL)
- …include: + Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health ... auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. + Free counseling… more
- Planate Management Group LLC (Miami, FL)
- …facilities engineering services worldwide. Planate is a small business provider of planning, design, infrastructure management, technical consulting, engineering, ... quality control, and submittal reviews beyond the expertise of construction managers + Provide quality assurance for ongoing projects, and serve as a mentor to fewer… more
- Parsons Corporation (Miami, FL)
- …for minority, female, disabled, protected veteran and LGBTQ+. We truly invest and care about our employee's wellbeing and provide endless growth opportunities as ... from our deep pool of talent will support this new position to provide our clients with quality designs that incorporate innovation and are delivered on… more
- MyFlorida (Fort Lauderdale, FL)
- …Core Contract Oversee the development of the agency's annual state/county contract . Monitor and provide variance reports required by the contract ... receivable; travel; fee collections; third party billing; grants and contract billings; Environmental Health cashiering, in accordance with appropriate regulatory… more
- Parsons Corporation (Doral, FL)
- …for minority, female, disabled, protected veteran and LGBTQ+. We truly invest and care about our employee's wellbeing and provide endless growth opportunities as ... a team of professionals to deliver high-quality, innovative, and cost -effective solutions that meet client requirements and regulatory standards. Additionally,… more
- Elevance Health (Miami, FL)
- …programs. The **Audit and Reimbursement Lead** will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for Medicare and ... Under direction of management, the Audit and Reimbursement Lead will provide technical leadership, supervision and coordination on contractual workload involving the… more
- Elevance Health (Miami, FL)
- …most complex or elevated medical issues. Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient ... contracts. + Ensures member access to medical necessary, quality healthcare in a cost -effective setting according to contract . + Consult with clinical reviewers… more
- STERIS (Fort Lauderdale, FL)
- …a leading global provider of products and services that support patient care with an emphasis on infection prevention. WE HELP OUR CUSTOMERS CREATE A HEALTHIER ... the operational goals of the department Quality Delivery and Cost (QDC). Responsible for personnel coaching and development to...field service reports (FSR). + Works collaboratively with the Contract and Pricing team to assist in the development… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …to the Pharmacy Director and Part D Manager. Key Responsibilities: + Provide support in obtaining supporting statements and clinical information necessary for ... Enter and maintain accurate prior authorization records + Answer provider calls as this is a provider ...Utilization Management Department with Part B drug requests (eg Cost review, entering Part B authorizations/overrides, where applicable) +… more
- Sedgwick (Miami, FL)
- Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our ... benefits due, and manages action plan pursuant to the claim or client contract . + Manages subrogation of claims and negotiates settlements. + Communicates claim… more
- Veolia North America (Florida City, FL)
- …This position leads strategic planning, proposal coordination, estimating, sales support, contract development / contract relations, and design review and ... quality product, on time and at the lowest achievable cost consistent with overall business objectives. **PRIMARY DUTIES /...interpersonal and problem resolution skills. Works to identify and provide opportunities for team to learn new skills and… more
- Elevance Health (Hialeah, FL)
- …and to promote effective use of resources. Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient ... member access to medical necessary, quality healthcare in a cost effective setting according to contract . +...and/or medical directors to ensure medically appropriate, high quality, cost effective care throughout the medical management… more
- ChenMed (Miami, FL)
- …you inspire others with your kindness and joy? We're different than most primary care providers. We're rapidly expanding and we need great people to join our team. ... The Corporate Counsel will provide support to the Chen Family of Companies in a myriad of areas including, but not limited to, to business and employment contracts,… more