- Molina Healthcare (Jacksonville, FL)
- …and distribute standard reports on schedule + Position reports to AVP, Payment Integrity Analytics **JOB QUALIFICATIONS** **REQUIRED EDUCATION** : + Bachelor's ... and/or Project management experience. + Managed Care experience - **_specifically within Payment Integrity , Claims Payment , Provider Relations Experience_**… more
- Molina Healthcare (Jacksonville, FL)
- …work of external vendors. Assigns, directs and monitors system analysis and program staff. These positions' primary focus is project/ program management. **Job ... of external vendors. + Focuses on process improvement, organizational change management, program management and other processes relative to the business. + Leads and… more
- Molina Healthcare (Jacksonville, FL)
- …This role focuses on identifying and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will ... lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +...6 years of experience as a Business Analyst or Program Manager in a Managed Care Organization… more
- Molina Healthcare (Jacksonville, FL)
- …workflows and controls across intake, adjudication, adjustments, appeals/grievances, and payment integrity . + Technology Enablement: Oversee requirements, ... (Healthcare/Claims)** + Deep understanding of claims lifecycle, EDI transactions, payment integrity , provider data, appeals/grievances, and audit/compliance… more
- Navy Exchange Services (NEX) (Jacksonville, FL)
- Title: MICRO MARKET MANAGER (%3E$5M) Location: United States-Florida-Jacksonville Job Number: 250001IR Job Summary: - Personally directs or through subordinate ... - Works under the general direction and supervision of the manager who outlines policies, procedures and objectives. Operates independently, within established… more
- Pep Boys (Jacksonville, FL)
- …is directly responsible for maintaining adequate shop productivity. The Store Manager will recruit, hire, develop, and provide inspirational leadership and direction ... related to all point of sale (POS) transactions, inventory integrity , reverse logistics and purchase for re-sale parts (OP)...and purchase for re-sale parts (OP) procurement and vendor payment practices. + Partner with the Fleet business team… more
- Molina Healthcare (Jacksonville, FL)
- …level of care, inpatient readmission, and any opportunity identified by the payment Integrity analytical team; makes decisions and recommendations pertinent to ... for medical claim review activities. Responsible for ensuring timely claims payment processes, providing counsel to members regarding coverage and benefit… more
- Commander, Navy Installations (Jacksonville, FL)
- …position is located within Commander Navy Region Southeast, Fleet and Family Readiness Program . The purpose of the position is to document time and attendance ... system for correspondence, reports, and payroll functions while protecting the integrity of Personally Identifiable Information (PII) as well as ensuring proper… more
- Air National Guard Units (Jacksonville, FL)
- …of fiscal reconciliations, reviews, and account adjustments. Reconciles Resource Center Manager (RCM) accounts ensuring data integrity . Coordinates with the ... 1. PCS: Permanent Change of Station (PCS) costs, MAY be authorized. Authorization for payment of PCS expenses will be granted ONLY after determination is made that … more
- Molina Healthcare (Jacksonville, FL)
- …Level of Care, Inpatient Readmission, and any opportunity identified by the Payment Integrity analytical team; requires decision making pertinent to clinical ... database + Provides supporting documentation for denial and modification of payment decisions + Independently re-evaluates medical claims and associated records by… more
- IKO (Jacksonville, FL)
- …has many years of unparalleled success in the roofing materials industry. Quality, integrity , and trustworthiness are the values that underlie this success, and we ... Job Description Role: Purchasing Coordinator Job Summary: Reporting to the Plant Manager , the Purchasing Coordinator is responsible for procuring all supplies and… more