Top 53 Claims supervisor Jobs in Bradenton, Fl

Risk & Quality Performance Manager (Remote)
Molina Healthcare —Saint Petersburg, FL
- $66,456 - $129,590 a year
- Full-time
- Remote
- Microsoft Excel
- Azure
- Mid-level
- Health insurance
Roll Off Supervisor in Manatee!
Waste Pro —Sarasota, FL
- Weekends as needed
- CDL B
- Computer literacy
- Sanitation
Quick Apply
7d
Community Manager - Arietta
Greystar Real Estate Partners LLC —Sarasota, FL
- Weekends as needed
- Word processing
- Mid-level
- Office
- Paid parental leave
- Paid holidays
13d
Manager, Major Case Unit
FCCI Services Inc. —Sarasota, FL
- $114,640 - $176,546 a year
- 6 years
- Pass drug screening
- Bachelor's degree
- Profit sharing
- Paid holidays
Quick Apply
8d
Revenue Cycle Manager
Easter Seals Southwest Florida, Inc —Sarasota, FL
- Full-time
- Mid-level
- 3 years
- Bachelor's degree
- 403(b) matching
- Health insurance
Quick Apply
Revenue Cycle Manager
Easterseals Southwest Florida —Sarasota, FL
- Full-time
- Mid-level
- 3 years
- Bachelor's degree
- 403(b) matching
- Paid holidays
Assistant General Manager- HOA
Castle Group —Lakewood Ranch, FL
- Extended hours
- Microsoft Excel
- Microsoft Outlook
- Mid-level
14d
Restoration Sales & Project Manager
DRYmedic Restoration of Lakewood Ranch, FL —Lakewood Ranch, FL
- $65,000 - $75,000 a year
- Full-time
- Hybrid work
- Background check
- Mid-level
- Driver's License
- Paid holidays
- Paid time off
Quick Apply
5d
Office Manager - Hourly
COAST DENTAL —Sarasota, FL
- Background check
- Dental office
- Microsoft Excel
Quick Apply
Assistant Property Manager - Condo
Castle Group —Lakewood Ranch, FL
- Extended hours
- Microsoft Excel
- Microsoft Outlook
- Mid-level
PROPERTY UNIT MANAGER
ONE ALLIANCE INSURANCE MANAGERS INC —Sarasota, FL
- Full-time
- Spanish
- Microsoft Excel
- Office
Quick Apply
7d
Brand Activation Manager
Advantage Solutions —Sarasota, FL
- $68,640 - $78,000 a year
- Weekends as needed
- Microsoft Excel
- Up to 50% travel
- Computer literacy
- Opportunities for advancement
AR Revenue Cycle Manager
Dental Care Alliance —Sarasota, FL
- Full-time
- Senior level
4d
Insurance Verification Manager
Dental Care Alliance —Sarasota, FL
- Full-time
- Bachelor's degree
- Experience equivalent to degree accepted
- Senior level
6d
Workers Compensation Claims Supervisor
Acrisure, LLC —Bradenton, FL
- Continuous improvement
- Children
- Travel
- Commuter assistance
- Paid parental leave
13d
Office Manager - Hourly
Coast Dental and Orthodontics —Sarasota, FL
- Background check
- Dental office
- Microsoft Excel
Quality Manager I
The Walsh Group —Bradenton, FL
- Full-time
- Construction site
- Bachelor's degree
- Team management
Assistant Property Manager- HOA
Castle Group —Lakewood Ranch, FL
- Extended hours
- Microsoft Excel
- Microsoft Outlook
- Mid-level
7d
Manager Revenue Cycle Management
LIGHTSHARE BEHAVIORAL WELLNESS & RECOVERY —Sarasota, FL
- Full-time
- 5 years
- HIPAA
- Finance
Quick Apply
Manager, Statistical Reporting
FCCI Services Inc. —Sarasota, FL
- $103,360 - $159,175 a year
- 6 years
- Customer service
- Pass drug screening
- Profit sharing
- Paid holidays
Quick Apply

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claims supervisor jobs near bradenton, fl

Risk & Quality Performance Manager (Remote)

Molina Healthcare -
Saint Petersburg, FL

Apply Now

Job Details

Full-time
$66,456 - $129,590 a year

Benefits

Health insurance

Qualifications

Project development phase management
Microsoft Excel
Performance Reporting
Data summary reports
SQL
Project management experience in healthcare
Managing projects
Productivity software
Microsoft Project
Query management
Cross-functional collaboration
Clinical data analysis
Cross-functional team management
Technical Proficiency
Cross-functional communication
HEDIS

Full Job Description

Job Description

Job Summary

The Risk & Quality Performance Manager position will support Molina's Risk & Quality Solutions (RQS) team. This position collaborates with various departments and stakeholders within Molina to plan, coordinate, and manage resources and execute performance improvement initiatives in alignment with RQS's strategic objectives.

Job Duties

Collaborate with Health Plan Risk and Quality leaders to improve outcomes by managing Risk/Quality data collection strategy, analytics, and reporting, including but not limited to: Risk/Quality rate trending and forecasting; provider Risk/Quality measure performance, CAHPS and survey analytics, health equity and SDOH, and engaging external vendors.
Monitor projects from inception through successful delivery.
Oversee Risk/Quality data ingestion activities and strategies to optimize completeness and accuracy of EHR/HIE and supplemental data.
Meet customer expectations and requirements, establish, and maintain effective relationships and gain their trust and respect.
Draw actionable conclusions, and make decisions as needed while collaborating with other teams.
Ensure compliance with all regulatory audit guidelines by adhering to roadmap of deliverables and timelines and implementing solutions to maximize national HEDIS audit success.
Partner with other teams to ensure data quality through sequential transformations and identify opportunities to close quality and risk care gaps.
Proactively communicate risks and issues to stakeholders and leadership.
Create, review, and approve program documentation, including plans, reports, and records.
Ensure documentation is updated and accessible to relevant parties.
Proactively communicate regular status reports to stakeholders, highlighting progress, risks, and issues.

Job Qualifications

REQUIRED EDUCATION:

Bachelor's degree or equivalent combination of education and experience

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:

2+ years of program and/or project management experience in risk adjustment and/or quality
2+ years of experience supporting HEDIS engine activity, risk adjustment targeting and reporting systems
2+ years of data analysis experience utilizing technical skillsets and resources to answer nuanced Risk and Quality questions posed from internal and external partners
Familiarity with running queries in Microsoft Azure or SQL server
Healthcare experience and functional risk adjustment and/or quality knowledge
Mastery of Microsoft Office Suite including Excel and Project
Experience partnering with various levels of leadership across complex organizations
Strong quantitative aptitude and problem solving skills
Intellectual agility and ability to simplify and clearly communicate complex concepts
Excellent verbal, written and presentation capabilities
Energetic and collaborative

PREFERRED EDUCATION:

Graduate degree or equivalent combination of education and experience

PREFERRED EXPERIENCE:

Knowledge of, and familiarity with, NCQA, CMS, and State regulatory submission requirements
Experience working in a cross-functional, highly matrixed organization
SQL proficiency
Knowledge of healthcare claim elements: CPT, CPTII, LOINC, SNOMED, HCPS, NDC, CVX, NPIs, TINs, etc.

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:

PMP, Six Sigma Green Belt, Six Sigma Black Belt Certification, and/or comparable coursework desired

#PJCorp

#LI-AC1

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: $66,456 - $129,590 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Apply Now

Refine Your Search

claims supervisor jobs in bradenton, fl

Risk & Quality Performance Manager (Remote)

Roll Off Supervisor in Manatee!

Community Manager - Arietta

Manager, Major Case Unit

Revenue Cycle Manager

Revenue Cycle Manager

Assistant General Manager- HOA

Restoration Sales & Project Manager

Office Manager - Hourly

Assistant Property Manager - Condo

PROPERTY UNIT MANAGER

Brand Activation Manager

AR Revenue Cycle Manager

Insurance Verification Manager

Workers Compensation Claims Supervisor

Office Manager - Hourly

Quality Manager I

Assistant Property Manager- HOA

Manager Revenue Cycle Management

Manager, Statistical Reporting

I want to receive the latest job alert for claims supervisor in bradenton, fl

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