- Molina Healthcare (St. Petersburg, FL)
- …design solutions utilizing provider data such as the Provider Online Directory, Utilization Management , Customer Experience, Enrollment, and Claims ... **Job Description** **Job Summary** The Network Solutions Director is responsible for leading a team designing...combination of education and experience **Required Experience** 7-9 years Provider Data **Preferred Education** Graduate Degree or… more
- Molina Healthcare (St. Petersburg, FL)
- … Information process functions. * Directs the development, implementation and maintenance of provider data in the claims payment system. * Supports critical ... databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of… more
- Molina Healthcare (St. Petersburg, FL)
- …optimization, and service delivery + Overseeing implementation of scalable solutions for provider onboarding, data management , and credentialing operations + ... **JOB DESCRIPTION** **Job Summary** Lead operational readiness initiatives across provider data and credentialing functions, supporting both new implementations… more
- Molina Healthcare (St. Petersburg, FL)
- …and ensure adherence to business, system and regulatory requirements of Provider Data Management /Network Adequacy. **Knowledge/Skills/Abilities** + ... work with other teams including New Markets team, Network Management , Product Teams, PDM and IT. **Job Qualifications** **REQUIRED...EXPERIENCE:** + Advanced Excel skills. + Power BI. + Provider Data Analytics. To all current Molina… more
- Raymond James Financial, Inc. (St. Petersburg, FL)
- …mitigate operational and compliance risks. **Skill in** + Applying QA/QC tools, case management systems, and data analytics platforms to work processes. + ... The Director of Quality Assurance & Control covering Anti-Money...& Control covering Anti-Money Laundering (AML) & Financial Crimes Management (FCM) is responsible for leading a team of… more
- Raymond James Financial, Inc. (St. Petersburg, FL)
- …fund manager interactions. Upon completion of review, it is expected that that Director provide a supported recommendation within written reports based on ... **Job Summary:** Under very limited supervision, the Director of Alternative Investment Operational Due Diligence utilizes...information from professional publications * Meet many deadlines to provide quarterly and monthly data to internal… more
- Lake Erie College of Osteopathic Medicine (Bradenton, FL)
- Assistant Director of Network Operations Overview Date Posted: 9/24/2025 Location: Bradenton Address: 5000 Lakewood Ranch Blvd. City: Bradenton State: FL Country: ... Information Technology Employment Status: Full-time Description JOB SUMMARY : The Assistant Director of Network Operations reports to the Director of Network… more
- Raymond James Financial, Inc. (St. Petersburg, FL)
- …Minimum of 10 yrs domain experience in Financial Services -Required. + Business analysis, data analysis, project management . - Required + Experience in querying ... and describe the changes required to migrate to the future state; provide support for application development teams including documentation of current and future… more
- Raymond James Financial, Inc. (St. Petersburg, FL)
- …Industry-leading tools and frameworks for project management , source code management , defects and data quality aspects; Enterprise workflow orchestration ... Regulatory technology projects while driving continuous improvement to project management methodologies. Manage project teams throughout the project lifecycle… more
- Molina Healthcare (St. Petersburg, FL)
- …regarding utilization practices, guideline usage, pharmacy utilization and effective resource management . + Develops and implements a Utilization Management ... activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare, Medicaid,… more
- Molina Healthcare (St. Petersburg, FL)
- …of value-based care models, provider enablement strategies, and population health management . + Strong knowledge of data integration, EMR systems, and ... programs focused on provider enablement, ensuring access to tools, training, and data for success in VBC models. + Design and implement VBC training programs,… more
- Molina Healthcare (St. Petersburg, FL)
- …HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization/Quality Program management + Previous ... Assists in recruitment, hiring and training of staff as needed. + Analyzes data and identifies medical cost savings and quality improvement opportunities. + Accounts… more
- Sanofi Group (St. Petersburg, FL)
- …years' experience in the pharmaceutical/healthcare industry + 5-7+ years in account management and healthcare administration, with expertise in data analysis and ... **Job Title:** Regional CPE Director , Tzield Mid South /South Atlantic/Southeast **Location:** Remote, US **About the job** **Role Overview:** The Regional Care Path… more
- Zelis (St. Petersburg, FL)
- …and the personal interests that shape who you are. Position Overview The Director , Product Management is responsible for leading the product management ... products. + Stay updated on industry trends, emerging technologies, and product management methodologies. + Review product performance data using key performance… more
- Arrow Electronics (St. Petersburg, FL)
- **Position:** Sales Strategy Director - Tanzu Line of Business **Job Description:** We are seeking a dynamic and strategic Sales Strategy Program Director to ... markets (EMEA, NA) by collaborating with cross-functional teams, including program management , pricing, marketing, and product management . The ideal candidate… more
- Molina Healthcare (St. Petersburg, FL)
- …* Provides direct oversight, monitoring and training of local plans' provider dispute and appeals units to ensure adherence with Medicare standards ... and requirements related to non-contracted provider dispute/appeals processing. * Establishes member and non-contracted provider grievance/dispute and appeals… more
- Publicis Groupe (St. Petersburg, FL)
- **Overview** **How You'll Make an Impact** The Senior Director , Delivery Operations is a critical leader within Epsilon's retail media organization, responsible for ... planning for the team + Interviews, hires, and trains management -level staff in the department. + Oversees the daily...We'll Create Something EPIC Together** Epsilon is a global data , technology and services company that powers the marketing… more
- Molina Healthcare (St. Petersburg, FL)
- …compliance program, including annual, periodic, focal, etc. audits. * Performance Management & KPI Expertise: Develop, implement, and monitor KPIs, including leading ... adherence, diagnose root causes of misses, and drive accountability across functions. * Data Insight & Decision Support: Ingest and interpret complex data from… more
- Grifols Shared Services North America, Inc (Sarasota, FL)
- …solutions and services in more than 110 countries and regions. The Director , Pricing & Access Analytics is responsible for developing and applying advanced ... + Track win/loss trends to refine pricing and contracting strategies. Provide insights into pricing and contracting performance and recommend adjustments based… more
- Raymond James Financial, Inc. (St. Petersburg, FL)
- …of data + Intermediate Tableau knowledge and skills + Firm enterprise data management systems and policies + Intermediate level concepts, practices and ... and appropriate record retention + Compile and manipulate portfolio data and create reports used in senior management...within a team environment + Handle stressful situations and provide a high level of client service in a… more