- Molina Healthcare (St. Petersburg, FL)
- …and ensure adherence to business, system and regulatory requirements of Provider Data Management / Network Adequacy. **Knowledge/Skills/Abilities** + ... among multiple systems to ensure accurate reporting of the Provider Network across the enterprise. Validate data...Integrates work with other teams including New Markets team, Network Management , Product Teams, PDM and IT.… more
- Molina Healthcare (St. Petersburg, FL)
- …and system requirements of customers as it pertains to contracting, network management and credentialing. + **Knowledge/Skills/Abilities** + Strategically plans, ... **Job Description** **Job Summary** The Network Solutions Director is responsible for...solutions utilizing provider data such as the Provider Online Directory, Utilization Management , Customer Experience,… more
- Molina Healthcare (St. Petersburg, FL)
- …and system requirements of customers as it pertains to contracting, network management and credentialing. **Knowledge/Skills/Abilities** * Strategically plans, ... in developing and implementing appropriate Corrective Action Plans for submission of provider network files, etc. * Engages with IT and other departments to… more
- Molina Healthcare (St. Petersburg, FL)
- … and senior leadership/ management . * Communicates new strategies to corporate provider network leadership for input. * Utilize standardized system(s) to ... Georgia _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for...including VBP program templates. Works with Legal and Corporate Network Management as needed to modify contract… 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 ... Employment Status: Full-time Description JOB SUMMARY : The Assistant Director of Network Operations reports to the...Network Operations and IT policies and procedures; + Provide immediate problem resolution or escalation to the appropriate… more
- Molina Healthcare (St. Petersburg, FL)
- …as meeting or exceeding productivity standards. Educates and interacts with network and group providers and medical managers regarding utilization practices, ... guideline usage, pharmacy utilization and effective resource management . + Develops and implements a Utilization ...(QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
- BMO Financial Group (Sarasota, FL)
- …policies. While the primary focus is on technical trust administration, the Director will also support relationship management and business development ... as a client-facing individual contributor on a high performing team. The Director of Trust Administration is responsible for overseeing the administration of… more
- Catalent Pharma Solutions (St. Petersburg, FL)
- Director of Engineering and Facilities Catalent, Inc. is a leading global contract development and manufacturing organization (CDMO) whose mission is to develop, ... molecules into softgel, ideal for challenging fill formulation. Within the Catalent network , we offer a broad range of integrated formulation and analytical services… more
- Molina Healthcare (St. Petersburg, FL)
- …+ Maintains contractual relationships with significant/highly visible providers. + Advises Network Provider Contract Coordinators and Specialists on negotiation ... provider and routine ancillary contracts. + Evaluates provider network and implement strategic plans with...models. Seeks input on new reimbursement models from Corporate Network Management and legal. + Educates internal… more
- Zelis (St. Petersburg, FL)
- …and enhancing fraud mitigation frameworks to protect the integrity of our payments and provider network . This role will manage a team that investigate suspicious ... that shape who you are. Position Overview The Fraud Manager, Payee Identification and Network Security will report to the Sr. Director that leads Zelis Payments'… more
- Fresenius Medical Center (Venice, FL)
- …statements with Director + Responsible for participating in all required Network reporting and on-site state or federal surveys. + Participates in the completion ... for unexcused and missed treatments in collaboration with the Director . + Plans, coordinates and acts as the liaison...performance management , and decision making. + Demonstrated management skills necessary to provide leadership in… more
- Sarasota County Government (Sarasota, FL)
- …Lead the future of the Transportation Department. What you will do + Provide executive level leadership and management to the Transportation Planning and ... (PE) license and possess executive-level leadership experience in transportation operational management within a Metropolitan Planning context? In this role, you… more
- Jabil (St. Petersburg, FL)
- …and management of global employee benefit plans. You will provide analytical support, ensure compliance with regulatory requirements, and drive process ... 50 years of experience across industries and a vast network of over 100 sites worldwide, Jabil combines global...+ Perform audits of internal systems, payroll deduction files, provider records, and data exchanges to maintain accuracy and… more
- Jabil (St. Petersburg, FL)
- …monitor global quality costs and cost trends, striving continuously to improve value + Provide feedback to peers and senior management on quality cost and trends ... 50 years of experience across industries and a vast network of over 100 sites worldwide, Jabil combines global...transfer activities and participating in launch activities as needed. Provide support and technical assistance to new facility and/or… more
- HCA Healthcare (Sarasota, FL)
- …for scheduled surgery center patients. Under the supervision of the CBO Director or Business Office Manager, you will be responsible for payment collection ... HMO, or other Managed Care Organizations + You will contact patients and provide updates on benefit verification information and financial responsibility + You will… more
- BayCare Health System (St. Petersburg, FL)
- …the team that is revolutionizing health care - BayCare Health System Our network consists of 16 community-based hospitals, a long-term acute care facility, home ... utilization of human and product resources to efficiently and effectively provide medical imaging services and quality patient outcomes.** Accountable for and… more
- Zelis (St. Petersburg, FL)
- …are. Position Overview The Manager, of Account Services will report to the Senior Director of the Payee Identification and Network Security (PINS) team that ... team, ensuring timely, accurate and customer-focused handling of cases. + Provide coaching, feedback, and support to specialists handling account servicing,… more