- Elevance Health (Miami, FL)
- ** Cost of Care / Provider Contracting Data Analyst** **Location** : This role requires associates to be in-office 1-2 days per week, fostering ... an accommodation is granted as required by law. The ** Cost of Care / Provider Contracting...or any combination of education and experience, which would provide an equivalent background **Preferred Skills, Capabilities, and Experiences:**… more
- Molina Healthcare (Miami, FL)
- …previous experience in contracting with large specialty or multispecialty provider groups. * 1-3 Years Managed Care experience **PREFERRED EXPERIENCE** ... **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible...with VBC providers that result in high quality and cost -effective care . Maintains tracking system and publishes… more
- Fortive Corporation (Miami, FL)
- …For you, for us, for growth. **About Gordian** Gordian is the world's leading provider of facility and construction cost data, software and services for all ... assist Gordian in our effort to continue to be the premier Job Order Contracting (JOC) consulting agency. JOC is a procurement method and construction process that… more
- Molina Healthcare (Miami, FL)
- …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...departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations. + Maintains SharePoint… more
- Planate Management Group LLC (Florida City, FL)
- …facilities engineering services worldwide. Planate is a small business provider of planning, design, infrastructure management, technical consulting, engineering, ... support services for the Department of Veterans Affairs (VA) Network Contracting Office 4 (NCO4). This mid-level role requires a comprehensive understanding… more
- Planate Management Group LLC (Florida City, FL)
- …facilities engineering services worldwide. Planate is a small business provider of planning, design, infrastructure management, technical consulting, engineering, ... over the world. We are seeking a skilled Contract Specialist I to provide professional acquisition support services within the Department of Veterans Affairs (VA)… more
- Planate Management Group LLC (Florida City, FL)
- …facilities engineering services worldwide. Planate is a small business provider of planning, design, infrastructure management, technical consulting, engineering, ... Veterans Affairs. This senior-level position requires extensive expertise in contracting , including construction, complex services, and leasing procurements. The… more
- Molina Healthcare (Miami, FL)
- …health plans on the financial impact. * Work independently to support and validate Provider Network contracting and unit cost management activities through ... problematic contracts. Supports multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by leveraging… more
- Molina Healthcare (Miami, FL)
- …health plans on the financial impact. + Work independently to support and validate Provider Network contracting and unit cost management activities through ... problematic contracts. Supports multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by leveraging… more
- Molina Healthcare (Miami, FL)
- …ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost -effective member care . Essential Job ... keeps executive leadership apprised. * Leads analysis of medical care cost and utilization data. * Leads...that interface with the segment including medical management, network contracting and provider relations, member services, claims… more
- Molina Healthcare (Miami, FL)
- …senior level clinicians and leaders from functional areas such as finance, health care services and provider contracting to translate analytic observations ... in medical coding/billing (UB04/1500 form). * Advanced understanding of key managed care concepts and provider reimbursement principles such as risk adjustment,… more
- CDM Smith (Miami, FL)
- … cost estimates and supporting analysis in coordination with government cost estimators and contracting officers. * Participate in pre-construction meetings, ... and prepares technical reports and/or project status reports. * Provide engineering judgment for field modifications, non-conformance issues, value engineering… more
- Molina Healthcare (Miami, FL)
- …HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost -effective based on the severity ... that support ongoing improvements of clinical operations functions and promote quality cost effective health care for Molina members. + Develops initiatives… more
- Molina Healthcare (Miami, FL)
- …etc. **PREFERRED EXPERIENCE:** + Peer Review, medical policy/procedure development, provider contracting experience. + Experience with NCQA, HEDIS, ... through continuum among hospitals, skilled nursing facilities and home care to ensure quality, cost -efficiency, and continuity of care . + Ensures that… more
- EMCOR Group (Miami, FL)
- …advanced electrical systems. Our expertise spans traditional electrical contracting , security solutions, audio-visual integration, wireless networking, and building ... managers, clients, suppliers, and team members.** **Benefits include Family Medical Care Plan, National Electrical Benefit Fund & National Electrical Annuity Plan.**… more
- Black & Veatch (Coral Gables, FL)
- …medium to high-risk profiles * Manage multiple pursuits of differing revenue, contracting structures, complexities and schedules at a given time Professionals in ... leadership, while gaining exposure to all client types, delivery methods, contracting models and project risk profiles. Professionals in this role interface… more
- HCA Healthcare (Miami, FL)
- …the patient and the patient's family first, and the really great institutions will provide care with warmth, compassion, and dignity for the individual."- Dr. ... medical coverage that covers many common services at no cost or for a low copay. Plans include prescription...and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. +… 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. ... Working with limited guidance, the Senior Analyst VBC (Value Based Care ) Performance is responsible for proactively tracking the risk positions within ChenMed and… more
- Molina Healthcare (Miami, FL)
- …for Medicaid, Marketplace and Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims, Pharmacy, Lab and HEDIS rates. + Assist ... interpolation, and other statistical methodologies to predict future trends in cost , utilization, and performance. + Assist with research, development and completion… more
- Carnival Cruise Line (Miami, FL)
- …development, delivery, and gap analysis across fleet and shoreside operations. Provide compliance reporting, identifies risks, and proposes mitigation strategies to ... and oversees the 3rd Party Commissioning Framework to ensure quality, compliance, and cost -effective training solutions Here is a summary of what Princess is looking… more