Medicaid Risk Adjustment Expert

We are seeking a highly skilled Clinical Coding Nurse Consultant to join our team in Orlando, FL. As a Clinical Coding Nurse Consultant, you will play a critical role in driving consistent and efficient processes for Risk Adjustment improvement initiatives.Job OverviewThe ideal candidate will have a strong background in nursing and experience working with...

Job SummaryWe are seeking a highly skilled Clinical Coding Nurse Consultant to join our team in Orlando, FL. As a key member of our Care Delivery team, you will be responsible for driving consistent and efficient processes, sharing best practices with Providers and Market Teams, and facilitating achievement of goals set for HCC Ratio, HCC Covered Ratio, and...

Job SummaryNorth American Risk Services, Inc. (NARS) is a premier third-party claims administrator dedicated to delivering exceptional results for our clients.We are seeking a highly skilled Commercial Property Claims Adjuster to join our team in this exciting role!The ideal candidate will have 3 to 9 years of prior commercial claim adjusting experience or...

We are seeking a highly skilled Claims Specialist for Commercial Properties to join our team at North American Risk Services, Inc. (NARS). In this role, you will be responsible for handling a caseload of commercial property claims, investigating losses, determining coverage, and negotiating settlements.The ideal candidate will have 3-9 years of prior...

About the RoleWe are seeking a highly skilled Cybersecurity Risk Management Expert to join our team at Leidos. In this role, you will be responsible for implementing and executing risk management processes by utilizing National Institute of Standards and Technology (NIST) 800 series special publications, Federal Information Processing Standards (FIPS), and...

Actuarial Leadership OpportunityCentene Corporation invites applications for a Senior Actuary position. As a key member of the Risk Adjustment team, you'll be responsible for leading data-driven analyses to drive change and improve outcomes, overseeing a portfolio of Medicaid Risk Adjustment initiatives, and ensuring timely and accurate updates to Risk...

Transforming Health CareYou have the opportunity to change the lives of 28 million members as a Senior Actuary at Centene Corporation. With a commitment to transforming the health of our communities, you'll have access to a comprehensive benefits package and competitive pay. The estimated salary for this role is $120,000 - $180,000 per year.About the...

About the Job:We are currently recruiting for a Retail Pharmacy Expert - Field Reimbursement Manager to join our team in Orlando, FL. This FIELD/TRAVEL position will cover a territory and require expertise in retail pharmacy and specialty drug prior authorizations, appeals, and working denials.Your Key Responsibilities:Manage a territory of retail pharmacies...

Job Title: Personal Risk Protection SpecialistOverviewAs a Personal Risk Protection Specialist at Harry Levine Insurance, you will play a vital role in helping individuals and families protect their assets and achieve peace of mind. Our agency takes pride in offering personalized insurance solutions that cater to the unique needs of our clients.Salary...

Job DescriptionAbout Loews Hotels, LLCWe are a world-class team that brings to life the incredible hotels located at Universal Orlando Resort. Named one of Central Florida's Top Workplaces and one of America's Best-in-State Employers by Forbes, we are committed to our power of 'we' culture.Job SummaryThis role is responsible for managing all workers...

Liberty Mutual is a leading insurance company that values people's hard work and commitment to making things better. We provide an environment focused on openness, inclusion, trust, and respect.We are seeking a Senior Industrial Hygienist for the Tampa, Orlando, and Fort Lauderdale territory. The successful candidate will design and conduct industrial...

OverviewOrlando Health Medical Group is a leading healthcare provider in Central Florida, dedicated to delivering exceptional patient care and innovative medical services. Our team of skilled professionals is committed to staying at the forefront of medical advancements, ensuring our patients receive the highest quality treatment and care.Salary: $250,000 -...

RemX | The Workforce ExpertsJob Title: Field Reimbursement ManagerWe are seeking an experienced Field Reimbursement Manager to join our team in Orlando, FL.Job Summary:This is a FIELD/TRAVEL position covering a territory in Orlando, FL. As a Field Reimbursement Manager, you will be responsible for managing a large territory and working closely with...

Hearing Loss Prevention ExpertAbout the RoleAdventHealth Central Florida is seeking a skilled Hearing Loss Prevention Expert to join our team. As a Hearing Loss Prevention Expert, you will be responsible for identifying and preventing hearing loss in patients.Key Responsibilities:Evaluate patients for hearing loss risk factorsDevelop and implement strategies...

Job SummaryWe are seeking a highly organized and detail-oriented Risk Management Coordinator to join our team at Lakewood Regional Support Bldg. In this role, you will be responsible for managing all workers compensation claims, ensuring compliance with LHUO return to work policy, and maintaining property-specific OSHA compliant first aid logs.Key...

Job DescriptionWe are seeking a Clinical Coding Nurse Consultant to join our team in Tampa, FL. As a member of our Optum Care Delivery team, you will be an integral part of our vision to make healthcare better for everyone.About the RoleThe Sr. Clinical Coding Nurse Consultant will drive consistent, efficient processes and share best practices in a...

About Ethos Risk ServicesEthos Risk Services is a leading insurance claims investigation and medical management company, specializing in surveillance and fraud detection. Our mission is to provide accurate data and actionable insights that translate into better decision-making for our clients.Job OverviewWe are seeking a Full-Time Entry-Level Field...

About UsAt Orlando Health, we are committed to delivering exceptional care to the children and families of Central Florida. Our state-of-the-art facilities and team of dedicated experts provide a comprehensive range of services to meet the unique needs of our patients.Job SummaryWe are seeking an experienced Pediatric Registered Nurse to join our high-risk...

Our Team">We are a diverse team of experts passionate about delivering high-quality solutions that improve patient outcomes. Our team members are committed to excellence, collaboration, and innovation.">Job Summary">We are seeking a highly motivated Cybersecurity Threat Analyst to join our team. The ideal candidate will have a strong background in...

North American Risk Services, Inc. (NARS) is a premier third-party claims administrator dedicated to producing exceptional results for our clients. As a Claims Specialist for Commercial Properties, you will play a critical role in achieving this goal.In this role, you will handle a caseload of commercial property claims, working closely with clients and...