- Molina Healthcare (Miami, FL)
- …operation process designs and establishes procedures and techniques for operational standards. Confers with customers to define and resolve. ... **Knowledge/Skills/Abilities** Responsible for the oversight of regulatory compliance of Corporate Operations functions, including but not limited to performance of… more
- Molina Healthcare (Miami, FL)
- …and regulations, contract provisions, and internal policies and procedures. * Supports the Operational Oversight Manager, Director , and team in the general ... reporting exists to demonstrate compliance to regulatory requirements. * Supports Manager and Director with developing the Operational Oversight Work Plan,… more
- Molina Healthcare (Miami, FL)
- …on increased responsibility and adding value to the organization + Ensures strong operational processes are in place to deliver across all areas of responsibility + ... Provides oversight analyses of demographic data to support accurate Network Adequacy Reporting and Directory development. + Manage multiple resources and projects… more
- Molina Healthcare (Miami, FL)
- …to members or authorized representatives in accordance with Centers for Medicare and Medicaid standards/requirements. * Provides direct oversight , monitoring ... and implements process improvements to achieve member/provider satisfaction or operational effectiveness/efficiencies which contribute to Molina Medicare 's… more
- HCA Healthcare (Fort Lauderdale, FL)
- …This position is incentive eligible. **Job Summary and Qualifications** The Division Director of Ambulatory Clinical Quality will serve as the lead subject matter ... providers for HCA Physician Services. This will encompass providing oversight for the quality of care being provided by...providers and may increase as acquisitions occur). The Division Director of Ambulatory Quality is responsible for leading a… more
- Molina Healthcare (Miami, FL)
- …Encounters is responsible for establishing enterprise-wide strategy, governance, and oversight of processes that track, evaluate, and submit encounter deletions ... for Medicare Advantage, ACA, and Medicaid lines of business. This...accuracy & completeness (ie, Encounter Production, Audit, Production Vendor Oversight ) for assigned lines of business. Responsible for increasing… more
- University of Miami (Miami, FL)
- …+ Performs other duties as assigned by the Chief and/or clinic Medical Director + Experience with Medicare Advantage (65+) patient population preferred + ... and/or physician delegate, the Supervisor will be responsible for oversight of healthcare delivery provided by General Internal Medicine...Completion of Medicare annual wellness exam documentation preferred + Knowledge of… more