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Showing 209 Healthcare jobs in Tampa

Healthcare Quality Analyst

33603 Tampa, Florida Deloitte

Posted 2 days ago

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Job Description

Our Deloitte Strategy & Transactions team helps guide clients through their most critical moments and transformational initiatives. From strategy to execution, this team delivers integrated, end-to-end support and advisory services covering valuation modeling, cost optimization, restructuring, government operations modernization, business design and transformation, infrastructure and real estate, mergers and acquisitions (M&A), and sustainability. Work alongside clients every step of the way, helping them navigate new challenges, avoid financial pitfalls, and provide practical solutions at every stage of their journey-before, during, and after any major transformational projects or transactions.
Work You'll Do
+ Conduct reviews of medical exam documentation in accordance with established medical and legal requirements
+ Interact with healthcare professionals to provide report-specific feedback and assist in resolving discrepancies
+ Follow all processes and procedures related to program operations and safeguarding of personally identifiable information / personal health information
+ Consistently meet individual productivity and quality goals
The Team
Deloitte's Government and Public Services (GPS) practice - our people, ideas, technology and outcomes-is designed for impact. Serving federal, state, & local government clients as well as public higher education institutions, our team of professionals brings fresh perspective to help clients anticipate disruption, reimagine the possible, and fulfill their mission promise.
Our Operations Transformation offering provides NextGen core operational solutions and operating models, business-led technology support, and process optimization services, maximizing value to our government clients' missions.
Qualifications:
Required:
+ 1 year DBQ Review experience
+ Bachelors degree OR Associates degree plus 2 years of experience Or high school diploma plus 4 years of experience
+ Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future
Preferred Qualifications
+ MDEO (medical disability examination office) vendor experience
+ Experience conducting reviews of medical exam documentation in accordance with established medical and legal requirements
+ Understanding of Medical Terminology
+ Medical Benefit experience
+ Medical License (LVN, RN, etc.)
Information for applicants with a need for accommodation: qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or protected veteran status, or any other legally protected basis, in accordance with applicable law.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or protected veteran status, or any other legally protected basis, in accordance with applicable law.
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Customer Service Representative - Healthcare

33601 Tampa, Florida $16 annum Maximus

Posted 8 days ago

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Job Description

Permanent
Description & Requirements

Hiring Event!

English and Bilingual (English/Spanish) Customer Service Representatives

5701 E Hillsborough Ave Ste 1300, Tampa, FL 33610

Friday, October 24 th

10 a.m. - 12 p.m.

Confirm your interest!

Customer Service Representative - Healthcare

Location: On-site in Riverview or Tampa, FL

Hourly Base Pay: $1 5.61 plus a $50 new hire bonus and up to 2,200+ in other potential bonuses!*

Schedule: Limited-Service Full-Time schedules available ; the hours, schedule, and targeted start date are discussed with recruiter

Night shifts are highly desirable! We offer a 10% shift differential for any hours worked between 7 p.m. and 10 p.m.

Grow Your Career, Strengthen Communities, and Deliver Customer Care to America's Most Vulnerable.

Join Maximus as a Customer Service Representative (CSR) and take the first step toward a rewarding career that combines professional growth with purpose. You'll play a vital role in helping individuals access essential healthcare services-while gaining valuable, real-world experience along the way.

Whether you prefer a traditional weekday schedule or need weekend flexibility, Maximus has options for you. Our Tampa ( Netpark ) site is open Monday - Friday, 8 a.m. - 10 p.m. while our Riverview location operates Monday - Sunday, 6 a.m. - 10 p.m.

Pay and Benefits

At Maximus, we believe in the power of teamwork and mutual success. Our benefits reflect this philosophy by supporting your physical health, financial wellbeing, and work/life balance, ensuring you're equipped for all the moments that matter.

  • Competitive Compensation:

  • Base rate 1 5.61 / hr + 10% shift differential for evening shifts

  • 750 new hire bonus and up to 2,200+ in bonus opportunities, including training completion, referrals and more*

  • Tuition Reimbursement - Invest in your ongoing education and development

  • Work/Life Balance Support : Flexible scheduling options!

  • Comprehensive Insurance Coverage: Company paid, base employee Medical Coverage

  • Future Planning: 401k with company match

  • Paid Time Off Package: Paid accrued Sick Leave, PTO, and 11 paid holidays

  • Maximus Wellness Support: Employee Assistance Program (EAP), Employee Wellness, and Discount Programs

  • Professional Development Opportunities: A supportive environment with career development and promotional opportunities

  • Meaningful Work with Impact: No cold calling, sales, or collection calls!

*Eligibility requirements apply, ask your recruiter for more details

Essential Duties and Responsibilities:

- Provides customer service for basic and routine inquiries and problems via multiple possible channels (i.e. telephone, emails, web chats, or written letters).

- Calls are basic and routine.

- Uses computerized system for tracking, information gathering, and/or troubleshooting.

- Provides feedback when needed, provide input on call trends, processes, procedures, and training.

- May respond to customer inquiries by referring them to published materials, secondary sources, or more senior staff.

- Provide timely responses to telephone inquiries in a courteous and professional manner, using pre-scripted responses

- Follow policies and standard operating procedures such as filling out timesheets, adhering to privacy and HIPAA rules

- Utilize standard technology such as telephone, e-mail, and web browser to perform job duties

- Assist caller(s) with filling out online applications and submitting electronically to plan provider for processing

- Complete basic call log related to the phone inquiries such as clicking radio buttons to confirm which scripts were read to the caller

- Refer calls as required to CSR Lead

- Maintain up-to-date knowledge of client regulations and policies

- Report problems that occur via the online system so they can be addressed by the appropriate parties

Minimum Requirements

- High School diploma or equivalent with 6 months of customer service experience.

- Must be able to speak and read English clearly, professionally and fluently.

- Ability to work within established turnaround times

- Must have excellent interpersonal skills and the ability to organize simultaneous tasks

- Ability to work as a member of a team

- Must participate and certify in internal CCO training to begin this role.

- Medicare will be expected to participate in and certify in internal Tier I Claims Part A, Claims Part B, and Claims DME training at a later date to complete your Tier I training for this role.

- May be required to work overtime and scheduled holidays.

- Working on-site at our office location is a key requirement for this position. Being physically present at the worksite is essential for effective collaboration, communication, and supervision.

- Applicants must be able to perform their duties on-site and meet attendance requirements. Remote or at-home work options are not available for this role until completion of at least one year of employment with above-average performance, based on specified program criteria and at the company's discretion.

#CSRroles #CCORiverview #CCOallreqs

EEO Statement

Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.

Pay Transparency

For positions on this contract, Maximus will pay the prevailing wage rate for the location in which the employee is working, as determined by the Department of Labor. That wage rate will vary depending on locality. An applicant's salary history will not be used in determining compensation.

Accommodations
Maximus provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at .

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Business Consulting - Healthcare Transformation - Manager - Patient Access

33603 Tampa, Florida EY

Posted 2 days ago

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Job Description

At EY, we're all in to shape your future with confidence.
We'll help you succeed in a globally connected powerhouse of diverse teams and take your career wherever you want it to go. Join EY and help to build a better working world.
Today's healthcare environment in the post-COVID era is undergoing rapid change and transformation. As healthcare organizations seek to stabilize operations and plan for a financially sustainable future, they are challenged to integrate transformative technology (Artificial intelligence, automation, etc.), adjust to patient-focused operations, and maintain operational discipline to withstand increasing financial pressures. As a manager within our Health consulting practice, you'll work with clients across the healthcare industry, from hospitals and integrated delivery networks to commercial and governmental insurers. You'll use your industry knowledge and relationship skillsets to assist our clients in transforming operations to meet the evolving demands of today's healthcare market.
**The opportunity**
As part of EY's Health consulting practice, you will work with these clients across the country in solving complex problems in today's rapidly changing healthcare environment. We currently are seeking a highly motivated Manager, with a focus on provider operations, specifically patient access to manage client engagement teams, work with a wide variety of clients to deliver professional services and manage business development activities on strategic and global priority accounts.
**Your key responsibilities**
You'll spend most of your time teaming with our provider team working with a broad spectrum of not-for-profit and for-profit healthcare clients, including hospitals, healthcare systems, physician practices and academic medical centers, to assess and redesign clinical processes.
As a Manager in our Health consulting group focused on Provider Operations, you'll work with clients across the following areas:
+ Operational improvement
+ Benchmarking and financial quantification
+ Cost reduction/revenue enhancement
+ Workflow redesign
+ Patient access initiatives including template management, template optimization, and scheduling algorithms
**Skills and attributes for success**
+ Effectively manage and motivate client engagement teams with diverse skills and backgrounds. Foster an innovative and inclusive team -oriented work environment. Play an active role in counselling and mentoring junior consultants within the organization
+ Foster relationships with client personnel at appropriate levels. Consistently deliver quality client services. Drive high-quality work products within expected timeframes and on budget. Monitor progress, manage risk and ensure key stakeholders are kept informed about progress and expected outcomes
+ Cultivate and manage business development opportunities. Understand EY and its service lines and actively assess/present ways to serve clients. Develop and maintain long-term client relationships and networks
+ Demonstrate in-depth technical capabilities and professional knowledge
**To qualify for the role you must have**
+ A bachelor's degree and approximately 5 years of related work experience; or a master's degree and approximately 4 years of related work experience
+ Approximately 4 years of healthcare consulting experience, preferably with prior experience as a manager (or above), in a consulting firm or in a management role within industry
+ Required experience with patient access and centralized contact centers.
+ Ability to lead patient access initiatives which includes clinician management, template management, template optimization, referral management, and scheduling algorithms. Experience should include assessment, design, and implementation of template optimization and scheduling algorithms within an ambulatory setting.
+ Experience with centralization of patient access functions, including contact center staffing models and technology for various engagement channels
+ Ability to read and interpret hospital financial statements and contract terms, utilize complex financial models, experience with operational process mapping and experience with healthcare cost reduction planning and implementation
+ Experience with healthcare organization M&A, physician alignment, or financial margin improvement initiatives
+ Experience in selling and delivering projects that cover the full life cycle of assessment, design and implementation support
+ Assist in generating revenue within existing healthcare clients and in developing new prospects at the "C" level of large healthcare companies
+ Ability to manage a team of staff/senior consulting professionals
+ Ability to work collaboratively in a team environment (knows when to lead and when to follow)
+ Strong analytical and problem-solving skills, as well as excellent oral and written communication skills.
+ Ability to create work products within Microsoft's suite of applications, including but not limited to Excel models, Visio scheduling and referral workflows, and PowerPoint presentations.
+ A willingness to travel to meet client needs; travel is required as needed by the client.
**Ideally you'll also have**
+ A degree with an emphasis in Finance, Accounting, and/or Business; CPA, MBA, MHA and/or MPH
**What we look for**
We're interested in passionate leaders with strong vision and a desire to stay on top of trends in the healthcare industry. If you have a genuine passion for healthcare, this role is for you
**What we offer you**
At EY, we'll develop you with future-focused skills and equip you with world-class experiences. We'll empower you in a flexible environment, and fuel you and your extraordinary talents in a diverse and inclusive culture of globally connected teams. Learn more .
+ We offer a comprehensive compensation and benefits package where you'll be rewarded based on your performance and recognized for the value you bring to the business. The base salary range for this job in all geographic locations in the US is $128,400 to $35,300. The base salary range for New York City Metro Area, Washington State and California (excluding Sacramento) is 154,000 to 267,400. Individual salaries within those ranges are determined through a wide variety of factors including but not limited to education, experience, knowledge, skills and geography. In addition, our Total Rewards package includes medical and dental coverage, pension and 401(k) plans, and a wide range of paid time off options.
+ Join us in our team-led and leader-enabled hybrid model. Our expectation is for most people in external, client serving roles to work together in person 40-60% of the time over the course of an engagement, project or year.
+ Under our flexible vacation policy, you'll decide how much vacation time you need based on your own personal circumstances. You'll also be granted time off for designated EY Paid Holidays, Winter/Summer breaks, Personal/Family Care, and other leaves of absence when needed to support your physical, financial, and emotional well-being.
**Are you ready to shape your future with confidence? Apply today.**
EY accepts applications for this position on an on-going basis.
For those living in California, please click here for additional information.
EY focuses on high-ethical standards and integrity among its employees and expects all candidates to demonstrate these qualities.
**EY | Building a better working world**
EY is building a better working world by creating new value for clients, people, society and the planet, while building trust in capital markets.
Enabled by data, AI and advanced technology, EY teams help clients shape the future with confidence and develop answers for the most pressing issues of today and tomorrow.
EY teams work across a full spectrum of services in assurance, consulting, tax, strategy and transactions. Fueled by sector insights, a globally connected, multi-disciplinary network and diverse ecosystem partners, EY teams can provide services in more than 150 countries and territories.
EY provides equal employment opportunities to applicants and employees without regard to race, color, religion, age, sex, sexual orientation, gender identity/expression, pregnancy, genetic information, national origin, protected veteran status, disability status, or any other legally protected basis, including arrest and conviction records, in accordance with applicable law. 
EY is committed to providing reasonable accommodation to qualified individuals with disabilities including veterans with disabilities. If you have a disability and either need assistance applying online or need to request an accommodation during any part of the application process, please call 1-800-EY-HELP3, select Option 2 for candidate related inquiries, then select Option 1 for candidate queries and finally select Option 2 for candidates with an inquiry which will route you to EY's Talent Shared Services Team (TSS) or email the TSS at .
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Manager, Provider Contracting - Tampa, FL market - Healthcare

33603 Tampa, Florida The Cigna Group

Posted 2 days ago

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Job Description

**WORK LOCATION:** supports our **Tampa, FL market** - Candidate will be required to live in the Tampa, FL area
**Hybrid position** - will need to work in the office or visit Providers 3 days per week
The **Manager, Provider Contracting Network Management** serves as an integral member of the Provider Contracting Team and reports to the AVP, Provider Contracting. This role assists in developing the strategic direction and management of the day to day contracting and network management activities for a local given territory.
**DUTIES AND RESPONSIBILITIES**
+ Manages complex contracting and negotiations for fee for service and value-based reimbursements with hospitals and other providers (e.g., Hospital systems, Ancillaries, and large physician groups).
+ Builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy.
+ Initiates and maintains effective channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing and Service.
+ Contributes to the development of alternative network initiatives. Supports and provides direction to develop network analytics required for the network solution.
+ Works to meet unit cost targets, while preserving an adequate network, to achieve and maintain Cigna's competitive position.
+ Creates and manages initiatives that improve total medical cost and quality.
+ Drives change with external provider partners by assessing clinical informatics and offering consultative expertise to assist with total medical cost initiatives.
+ Prepares, analyzes, reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms.
+ Creates healthcare provider agreements that meet internal operational standards and external provider expectations. Ensures the accurate implementation, and administration through matrix partners.
+ Assists in resolving elevated and complex provider service complaints. Researches problems and negotiates with internal/external partners/customers to resolve highly complex and/or escalated issues.
+ Manages key provider relationships and is accountable for critical interface with providers and business staff.
+ Demonstrates knowledge of providers in an assigned geographic area through understanding the interrelationships as well as the competitive landscape.
+ Responsible for accurate and timely contract loading and submissions and interface with matrix partners for network implementation and maintenance.
+ May provide guidance or expertise to less experienced specialists.
**POSITION REQUIREMENTS**
+ **Should possess a bachelor's degree; preferably in the areas of Finance, Economics, Healthcare or Business related. Significant industry experience will be considered in lieu of a bachelor's degree.** MBA or MHA preferred.
+ **3+ years Managed Care contracting and negotiating experience involving complex delivery systems and organizations required.**
+ Experience in developing and managing key provider relationships
+ Knowledge of complex reimbursement methodologies, including incentive based models strongly preferred.
+ Demonstrated experience in seeking out, building and nurturing strong external relationships with provider partners.
+ Intimate understanding and experience with hospital, managed care, and provider business models.
+ Team player with proven ability to develop strong working relationships within a fast-paced, matrix organization.
+ The ability to influence both sales and provider audiences through strong written and verbal communication skills. Experience with formal presentations.
+ Customer centric and interpersonal skills are required.
+ Demonstrates an ability to maneuver effectively in a changing environment.
+ Superior problem solving, decision-making, negotiating skills, contract language and financial acumen.
+ Knowledge and use of Microsoft Office tools.
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
**About Cigna Healthcare**
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.
_Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws._
_If you require reasonable accommodation in completing the online application process, please email:_ _for support. Do not email_ _for an update on your application or to provide your resume as you will not receive a response._
_The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State._
_Qualified applicants with criminal histories will be considered for employment in a manner_ _consistent with all federal, state and local ordinances._
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Manager, Provider Contracting - Tampa, FL market - Healthcare

33601 Tampa, Florida Cigna

Posted 6 days ago

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Job Description

Permanent
WORK LOCATION: supports our Tampa, FL market - Candidate will be required to live in the Tampa, FL area

Hybrid position - will need to work in the office or visit Providers 3 days per week

The Manager, Provider Contracting Network Management serves as an integral member of the Provider Contracting Team and reports to the AVP, Provider Contracting. This role assists in developing the strategic direction and management of the day to day contracting and network management activities for a local given territory.

DUTIES AND RESPONSIBILITIES

  • Manages complex contracting and negotiations for fee for service and value-based reimbursements with hospitals and other providers (e.g., Hospital systems, Ancillaries, and large physician groups).
  • Builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy.
  • Initiates and maintains effective channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing and Service.
  • Contributes to the development of alternative network initiatives. Supports and provides direction to develop network analytics required for the network solution.
  • Works to meet unit cost targets, while preserving an adequate network, to achieve and maintain Cigna's competitive position.
  • Creates and manages initiatives that improve total medical cost and quality.
  • Drives change with external provider partners by assessing clinical informatics and offering consultative expertise to assist with total medical cost initiatives.
  • Prepares, analyzes, reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms.
  • Creates healthcare provider agreements that meet internal operational standards and external provider expectations. Ensures the accurate implementation, and administration through matrix partners.
  • Assists in resolving elevated and complex provider service complaints. Researches problems and negotiates with internal/external partners/customers to resolve highly complex and/or escalated issues.
  • Manages key provider relationships and is accountable for critical interface with providers and business staff.
  • Demonstrates knowledge of providers in an assigned geographic area through understanding the interrelationships as well as the competitive landscape.
  • Responsible for accurate and timely contract loading and submissions and interface with matrix partners for network implementation and maintenance.
  • May provide guidance or expertise to less experienced specialists.

POSITION REQUIREMENTS

  • Should possess a bachelor's degree; preferably in the areas of Finance, Economics, Healthcare or Business related. Significant industry experience will be considered in lieu of a bachelor's degree. MBA or MHA preferred.
  • 3+ years Managed Care contracting and negotiating experience involving complex delivery systems and organizations required.
  • Experience in developing and managing key provider relationships
  • Knowledge of complex reimbursement methodologies, including incentive based models strongly preferred.
  • Demonstrated experience in seeking out, building and nurturing strong external relationships with provider partners.
  • Intimate understanding and experience with hospital, managed care, and provider business models.
  • Team player with proven ability to develop strong working relationships within a fast-paced, matrix organization.
  • The ability to influence both sales and provider audiences through strong written and verbal communication skills. Experience with formal presentations.
  • Customer centric and interpersonal skills are required.
  • Demonstrates an ability to maneuver effectively in a changing environment.
  • Superior problem solving, decision-making, negotiating skills, contract language and financial acumen.
  • Knowledge and use of Microsoft Office tools.

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

About Cigna Healthcare

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: for support. Do not email for an update on your application or to provide your resume as you will not receive a response.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

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Provider Relations Lead Analyst - Cigna Healthcare - Remote

33601 Tampa, Florida Cigna

Posted 20 days ago

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Job Description

Permanent
This role delivers professional activities in the Provider Contracting job family. The position is responsible for dental provider recruitment and contracting as well as managing contracted provider relationships for a specified territory. Conducts daily outreach to dental offices or providers to develop and maintain positive relationships with the purpose of negotiating a contract for participation in our dental networks. Ability and willingness to travel frequently within the US including overnight stays. Conduct quality reviews of Practitioner and/or Facility/Ancillary contracts. Conducts comparison of contract data relative to provider data and/or demographic and reimbursement data submitted for processing. Assesses the accuracy of provider data processed in accordance with documented and standard operating policies and procedures. Applies standard techniques and procedures to routine instructions that require professional knowledge in specialist areas. Provides standard professional advice and creates initial reports/analyses for review. May provide guidance, coaching, and direction to more junior members of the team in the Network Management Organization.

Responsibilities:

  • Identifying, recruiting, contracting, and retaining qualified health care professionals in geographic area within established guidelines to meet health plan needs
  • Achieve competitive and cost-effective contracts in assigned areas or assigned client/customer needs
  • Negotiate contracts and recruit dental providers to become a Cigna network provider
  • Explain plans, policies, and procedures to potential providers
  • A point of contact for Providers who are contracted within a specified target market (Florida, Puerto Rico & Virgin Islands)
  • Maintain positive relationships with health care professionals and their office staff extending high quality service
  • Conduct negotiations and ensure the smooth operation and administration of provider agreements
  • Support and retention of offices in our dental networks
  • Complete onsite quality assessments
  • Respond to provider inquiries, concerns, complaints, appeals and grievances
  • Provide ongoing product education to dentists and their staff
  • Work to achieve contract discounts with new providers and current providers through thoughtful negotiation
  • Use data and facts to identify and overcome objections
  • Prioritize and organize own work to meet deadlines, and reach established personal and department goals
  • Conduct ongoing support to contracted providers in our networks via telephone or by personal relationship visits.

Requirements:

  • High School Diploma or equivalent
  • 1-3 year experience in healthcare administration or provider relationship management, preferably experience working with Dental offices
  • Strong skill set required in the following areas: analytical, negotiations, financials, presentation skills, written and oral communication skills
  • Strong negotiation and communication skills
  • Self-Starter and organized
  • Intermediate proficiency in Microsoft Office products
  • Valid drivers license
  • The person in this position will report virtually and should be located within the territory of FL,PR, &VI

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

About Cigna Healthcare

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: for support. Do not email for an update on your application or to provide your resume as you will not receive a response.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

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Lead Analyst, Healthcare Analytics- Managed care analytics & financial contracts

33603 Tampa, Florida Molina Healthcare

Posted 2 days ago

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Job Description

**JOB DESCRIPTION**
***Candidates must be located in California and work PST hours.***
**Job Summary**
Performs research and analysis of complex healthcare 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 findings.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Develops, implements, and uses software and systems to support the department's goals.
+ Develops and generates ad-hoc and standard reports using SQL programming, excel , Databricks and other analytic / programming tools.
+ Coordinates and oversees report generation by team members and distribution schedule to ensure timely delivery to customers, ensuring the highest quality on every project/request. Responsible for error resolution, follow up and performance metrics monitoring.
+ Provides peer review of critical reports and guidance on programming / logic improvements; provides guidance to team members in their analysis of data sets and trends using statistical tools and techniques to determine significance and relevance.
+ Applies process improvements for the team's methods of collecting and documenting report / programming requirements from requestors to ensure appropriate creation of reports and analyses while reducing rework.
+ Manage the creation of comprehensive workflows for the production and distribution of assigned reports, document reporting processes and procedures.
+ Create new databases and reporting tools for monitoring, tracking, and trending based on project specifications.
+ Create comprehensive workflows for the production and distribution of assigned reports, document reporting processes and procedures.
+ Assist with research, development and completion of special projects as requested by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations.
+ Maintains SharePoint Sites as needed, including training materials and documentation archives.
+ Demonstrate Healthcare experience in contract modeling, analyzing relevant Financial and Utilization Metrics of Healthcare.
+ Must be able to act as a liaison between Finance and Network Contracting as well as other external teams.
+ Must have experience in Financial modeling, identifying Utilization mgmt. trends and monitor pair mix.
+ Experience with Medicaid contract analytics is highly preferred.
+ Experience working on Managed care analytics and healthcare reimbursement models is required.
+ Must be able to work in a cross functional team.
**JOB QUALIFICATIONS**
**Required Education**
Bachelor's Degree in Finance, Economics, Computer Science
**Required Experience**
+ 6+ years of progressive responsibilities in Data, Finance or Systems Analysis
+ Expert knowledge on SQL, PowerBI, Excel, Databricks or similar tools
**Preferred Education**
Bachelor's Degree in Finance, Economics, Math, Accounting or related fields
Preferred experience in Medical Economics and Strong Knowledge of Performance Indicators:
+ Proactively identify and investigate complex suspect areas regarding contract rate and related medical costs
+ Initiate in-depth analysis of the suspect/problem areas and suggest a corrective action plan
+ Apply investigative skill and analytical methods to look behind the numbers, assess business impacts, and make recommendations through use of healthcare analytics, etc.
+ Analysis of trends in medical costs to provide analytic support for finance, pricing, and actuarial functions
+ Multiple data systems and models
+ BI tools (Power BI)
**Preferred License, Certification, Association**
QNXT or similar healthcare payer applications
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $77,969 - $171,058 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Cardiac/Vascular Sonographer

33603 Tampa, Florida BayCare Health System

Posted 2 days ago

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Job Description

BayCare is currently in search of our newest **Echocardiography Vascular Tech** who is passionate about providing outstanding customer service to our community. BayCare's top priority is the health and well-being of our communities as Tampa Bay's leading multi-specialty group with more than 600 providers practicing 45 specialties in over 175 outpatient locations throughout the Tampa Bay and west central Florida regions.
**Position Details:**
+ **Location:** Tampa, FL
+ **Status:** Full Time (non-exempt)
+ **Shift:** 8:00 AM to 5:00 PM Monday through Friday
BayCare is all about making the most of your life and loving your career. BayCare provides an array of benefits to help you meet the daily challenges of balancing all aspects of your life and career goals.
+ Benefits (Health, Dental, Vision)
+ Paid time off
+ Tuition reimbursement
+ 401k match and additional yearly contribution
+ Yearly performance appraisals and team award bonus
+ Community discounts and more
**AND the Chance to be part of an amazing team and a great place to work!**
**The Echocardiography Vascular Tech is responsible for:**
+ Serve as a member of the Cardiovascular Team, engaged in the conduct and performance of Cardiac and Vascular Ultrasound / Doppler diagnostic testing.
+ Required to assist the physician and other related healthcare professionals in these technical areas and is responsible for all aspects of clinical support.
+ Functions independently with minimal supervision.
+ Performs other duties as assigned
**Required Certification and Licensure:**
+ Required BLS (Basic Life Support)
+ Required RCS (Registered Cardiac Sonographer) OR RDCS (Reg Diagnostic Card Sonograph) AND RVT (Reg Vascular Tech Cert) OR RVS (CCI Registered Vascular Specialist) certification after 1 year of hire.
**Education:**
+ **Required Technical School:** Echocardiography or Ultrasound; Preferred Associates
+ Preferred Associates in Science
**Experience:**
+ Preferred 5 years - Ultrasound experience
**Skills for Success:**
+ Clinical skills appropriate to position
+ Administrative and clerical skills
+ Work independently and with a team
+ Customer service and critical thinking skills
+ Equipment use and maintenance appropriate for position
+ Organizational and time management skills
+ Computer skills appropriate to position
+ Medical terminology use and understanding
+ Written and verbal communication skills
_Equal Opportunity Employer Veterans/Disabled_
**Position** Cardiac/Vascular Sonographer
**Location** Tampa | Clinical | Full Time
**Req ID** 84994
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Neurodiagnostic Tech I - Medical Group - Neurology Physician Office

33603 Tampa, Florida BayCare Health System

Posted 2 days ago

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Job Description

**Where Expertise Meets Compassionate Care!**
At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy that's built on a foundation of trust, dignity, respect, responsibility, and clinical excellence.
BayCare is currently in search of our newest **Neurodiagnostic Tech I** who is passionate about providing outstanding customer service to our community. BayCare's top priority is the health and well-being of our communities as Tampa Bay's leading multi-specialty group with more than 600 providers practicing 45 specialties in over 175 outpatient locations throughout the Tampa Bay and west central Florida regions.
+ **Status:** Full Time
+ Shift Days/Hours: Monday thru Friday 8:00 AM - 5:00 PM (May Vary)
+ **Location:** Plant City, FL - Will also travel to New Port Richey and Riverview as needed
+ **Weekend Work:** None
+ **On Call:** No
+ Always in person
**Unlock your Career Potential:** **Join our Medical Group Team and Enjoy our Outstanding Benefits!**
+ Medical benefits (Health, Dental, Vision)
+ 401(k) match and additional yearly contributions
+ Paid Time Off
+ Tuition reimbursement
+ Year performance appraisal and team award bonus
+ Extensive training and mentorship along with amazing career growth opportunities
+ Community discounts and more
+ **AND** **the chance to be part of an amazing team and a great place to work!**
**Responsibilities:**
+ Performing neurodiagnostic procedures including but not limited to, nerve conduction velocity, evoked potentials, electroencephalogram, polysomnograms, electronystagnograms, autonomic testing and related patient care to assist physician in diagnosing neuromuscular disorders.
+ Also assists the physician in the performance of electromyography and other associated clinical procedures including coverage of EEG Technician position.
**Requirements:**
+ Required 1 years of Electroneural experience
+ Required BLS (Basic Life Support)
+ Preferred - REDT (Neurology); Preferred - REEGT (EEG); Preferred - REPT (Neurology)
+ Required High School or Equivalent; Or - Technical - Neurology
+ Preferred - Associates - Related Field
_Equal Opportunity Employer Veterans/Disabled_
**Position** Neurodiagnostic Tech I - Medical Group - Neurology Physician Office
**Location** Plant City | Clinical | Full Time
**Req ID** 56932
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Home Health Administrator

33603 Tampa, Florida BayCare Health System

Posted 2 days ago

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Job Description

**There's home care and then there's BayCare HomeCare!**
At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy that's built on a foundation of trust, dignity, respect, responsibility and clinical excellence.
Join one of Florida's largest and most respected home care providers-consistently recognized as a top workplace. At BayCare HomeCare, every team member plays a vital role in improving the lives of our patients each day. We're looking for compassionate, driven professionals to lead with purpose-and we hope you're one of them.
BayCare HomeCare is currently seeking an experienced Home Health Administrator to join our leadership team in Tampa, FL. We're looking for a proven leader with a background in skilled home care to help drive continued growth and deliver exceptional care.
**Home Health Administrator position details:**
+ **Location:** BayCare HomeCare Tampa
+ **Status:** Full Time, Exempt
+ **Shift Hours:** 8:00 AM - 5:00 PM
+ **On Call:** No
When you become a BayCare leader, we support your personal and professional growth by offering a range of benefits, educational opportunities and a healthy work-life balance:
+ Benefits (Health, Dental, Vision)
+ Paid time off
+ Tuition reimbursement
+ 401k match and additional yearly contribution
+ Yearly performance appraisals and leadership award
+ Community discounts and more
+ Relocation assistance if eligible
+ **AND the Chance to be part of an amazing team and a great place to work!**
**Requirements:**
+ Associate's Nursing with RN License or Bachelor's degree in Health Care related field
+ 3 years home care experience and 3 years supervisory role in a related field
**The Home Health Administrator has the responsibility and accountability for:**
+ Planning, scheduling and staffing, coordinating, and delivering of all routine patient care services for designated agency size of more than $10 million in budgeted net revenue per year.
+ Special assignments as directed by the Director Home Care ensuring compliance with all applicable local, state and federal regulations and standards including The Joint Commission.
+ Works in conjunction with Director of Nursing and Home Care Supervisors to conduct quality improvement quarterly committee meetings, review of patient satisfaction data, conduct follow-up visits with referral sources and follow up with negative patient satisfaction surveys.
+ Ensures identified deficiencies are attended to and resolved in a timely manner.
+ Assures documentation, communication, and follow up occurs and completed with corporate responsibility for any complaints.
**Join us for a rewarding career, an incredible team, and a workplace you'll love!**
_Equal Opportunity Employer Veterans/Disabled_
**Position** Home Health Administrator
**Location** Tampa:HomeCare Tampa | Leadership | Full Time
**Req ID** 49981
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