Top 1372 Senior medical representative Jobs in Florida

Provider Relations Representative
Molina Healthcare —Sarasota, FL
- $19.84 - $38.69 an hour
- Full-time
- Medical office experience
- Mid-level
- Training & development
- Health insurance
Senior Health Educator- Clinical Transplant Nurse- Remote
Molina Healthcare —Fort Lauderdale, FL
- $49,930 - $97,363 a year
- Full-time
- Remote
- Customer service
- Research
- 3 years
- Health insurance
Senior Health Educator- Asthma Educator - Remote
Molina Healthcare —Florida
- $49,930 - $97,363 a year
- Full-time
- Remote
- Customer service
- Research
- 3 years
- Health insurance
Senior Health Educator- Pediatric Oncology/Hematology - Remote
Molina Healthcare —Orlando, FL
- $49,930 - $97,363 a year
- Full-time
- Remote
- Bachelor of Science
- Databases
- Organizational skills
- Health insurance
Insurance Verification Representative - Remote (Tri-County Area)
University of Miami —Medley, FL
- Full-time
- Remote
- Bilingual
- Computer literacy
- Mid-level
- Health insurance
- Dental insurance
HIV Hybrid Medical Science Liaison
EVERSANA —Orlando, FL
- $185,000 - $220,000 a year
- Full-time
- Hybrid work
- Bachelor of Science
- Doctor of Philosophy
- Travel
Quick Apply
Senior Medical Science Liaison - Obesity - FL
Amgen —Orlando, FL
- $172,344.30 - $233,171.70 a year
- Medicine
- Bachelor's degree
- Doctor of Philosophy
- Disability insurance
- Health insurance
Senior Business Analyst ( Remote ) ( Healthcare )
AssistRx —Orlando, FL
- Full-time
- Remote
- Background check
- 7 years
- Microsoft Outlook
- Disability insurance
- Health insurance
Quick Apply
Medical Science Liaison/Senior Medical Science Liaison – Hematology/Oncology - Southeast
EVERSANA —Tampa, FL
- $180,000 - $220,000 a year
- Full-time
- Remote
- Medicine
- Doctor of Philosophy
- Travel
- Paid training
- Paid holidays
Quick Apply
Talent Operational Excellence Project Manager
Raytheon —Tallahassee, FL
- $86,800 - $165,200 a year
- Full-time
- Remote
- Travel
- SharePoint
- Senior level
- Paid holidays
- Disability insurance
13d
Sr. Insurance Verification Representative (H)
University of Miami —Medley, FL
- Full-time
- Remote
- Mid-level
- Health insurance
- Dental insurance
13d
Senior Radiation Therapist
Sunstate Medical Specialists —Lauderdale Lakes, FL
- Full-time
- CPR Certification
- 5 years
- Computer literacy
Quick Apply
Senior Radiation Therapist
Sunstate Medical Specialists —Stuart, FL
- Full-time
- CPR Certification
- 5 years
- Computer literacy
Quick Apply
Director of Nursing
The Promenade - Concordis Senior Living —Sebastian, FL
- Weekends as needed
- Background check
- Nursing
- Microsoft Excel
- Wellness program
- Health insurance
Quick Apply
Senior Radiation Therapist
Sunstate Medical Specialists —Fort Pierce, FL
- Full-time
- CPR Certification
- 5 years
- Computer literacy
Quick Apply
Senior International SOF Engagement SME
Culmen International LLC —Tampa, FL
- Urgently hiring
- Master's degree
- 1 year
- Senior level
- Paid holidays
- Health insurance
1d
Senior Radiation Therapist
Sunstate Medical Specialists —Vero Beach, FL
- Full-time
- CPR Certification
- 5 years
- Computer literacy
Quick Apply
Senior Healthcare Construction Project Manager
Ajax Building Corporation —Tampa, FL
- Full-time
- Background check
- Construction site
- Bachelor's degree
- Health savings account
- AD&D insurance
Quick Apply
Traveling Senior Superintendent - Justice / Corrections
Ajax Building Corporation —Tampa, FL
- Full-time
- Background check
- Construction site
- 8 years
- Health savings account
- AD&D insurance
Quick Apply
Physician
MorseLife Health System —West Palm Beach, FL
- From $250,000 a year
- Full-time
- Background check
- Medicine
- Current TB test
- Free parking
- Health savings account
Quick Apply
10d

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Provider Relations Representative

Molina Healthcare -
Sarasota, FL

Apply Now

Job Details

Full-time
$19.84 - $38.69 an hour

Benefits

Health insurance

Qualifications

Customer communication
Managed care
Managed care organization experience
Medical office experience
Schedule management
Health insurance knowledge
Productivity software
Cross-functional collaboration
Cross-functional communication

Full Job Description

***Remote and must live in Charlotte, Lee, or Sarasota for provider visits***

JOB DESCRIPTION

Job Summary

Provides support for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary point of contact between the business and contracted providers within the Molina network. Responsible for network management including provider education, communication, satisfaction, issue intake, access/availability and ensuring knowledge of and compliance with Molina policies and procedures.

Essential Job Duties

Successfully engages high-volume, high-visibility plan providers, to ensure provider satisfaction, facilitate education on key Molina initiatives, and improve coordination and partnership between the health plan and contracted providers.
Serves as the primary point of contact between Molina health plan and the non-complex provider community that services Molina members, including but not limited to fee-for-service (FFS) and pay-for-performance (P4P) providers.
Collaborates directly with the plan’s external providers to educate, advocate and engage as valuable partners - ensuring knowledge of and compliance with Molina policies and procedures while achieving the highest level of customer service; effectively drives timely issue resolution, electronic medical record (EMR) connectivity, and provider portal adoption.
Conducts regular provider site visits within assigned region/service area; determines daily or weekly schedule, to meet or exceed the plan's monthly site visit goals. Proactively engages with the provider and staff to determine; for example, non-compliance with Molina policies/procedures or Centers for Medicare and Medicaid Services (CMS) guidelines/regulations, or to assess the non-clinical quality of customer service provided to Molina members.
Provides on-the-spot training and education as needed, including counseling providers diplomatically, while retaining a positive working relationship.
Independently troubleshoots provider problems as they arise, and takes initiative in preventing and resolving issues between the provider and the plan whenever possible. The types of questions, issues or problems that may emerge during visits are unpredictable and may range from simple to very complex or sensitive matters.
Initiates, coordinates and participates in problem-solving meetings between the provider and Molina stakeholders, including senior leadership and physicians (examples include: issues related to utilization management, pharmacy, quality of care, and correct coding).
Independently delivers training and presentations to assigned providers and their staff - answering questions that come up on behalf of the health plan; may also deliver training and presentations to larger groups, such as leaders and management of provider offices, including large multispecialty groups or health systems, executive level decision makers, association meetings, and joint operating committees (JOCs).
Performs an integral role in network management, by monitoring and enforcing company policies and procedures, while increasing provider effectiveness by educating and promoting participation in various Molina initiatives; examples of such initiatives include: administrative cost-effectiveness, member satisfaction - Consumer Assessment of Healthcare Providers and Systems (CAHPS), regulatory-related, Molina quality programs, and taking advantage of electronic solutions (electronic data interchange (EDI), EMR, provider portal, provider website, etc.).
May provide training and support to new and existing provider relations team members as appropriate.
Role requires 60%+ same-day or overnight travel (extent of same-day or overnight travel will depend on the specific health plan service area).

Required Qualifications

At least 2 years of customer service, provider services, or claims experience in a managed care or medical office setting, or equivalent combination of relevant education and experience.
General understanding of the health care delivery system, including government-sponsored health plans.
Organizational skills and attention to detail.
Ability to manage multiple tasks and deadlines effectively.
Interpersonal skills, including ability to interface with providers and medical office staff.
Ability to work in a cross-functional highly matrixed organization.
Effective verbal and written communication skills.
Microsoft Office suite and applicable software programs proficiency.

Preferred Qualifications

Familiarity with various managed health care provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including: fee-for service (FFS), capitation and various forms of risk, ASO, etc.
Experience delivering training and facilitating educational presentations.

#PJHPO

#LI-AC1

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $19.84 - $38.69 / HOURLY

Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Apply Now

Refine Your Search

senior medical representative jobs in florida

Provider Relations Representative

Senior Health Educator- Clinical Transplant Nurse- Remote

Senior Health Educator- Asthma Educator - Remote

Senior Health Educator- Pediatric Oncology/Hematology - Remote

Insurance Verification Representative - Remote (Tri-County Area)

HIV Hybrid Medical Science Liaison

Senior Medical Science Liaison - Obesity - FL

Senior Business Analyst ( Remote ) ( Healthcare )

Medical Science Liaison/Senior Medical Science Liaison – Hematology/Oncology - Southeast

Talent Operational Excellence Project Manager

Sr. Insurance Verification Representative (H)

Senior Radiation Therapist

Senior Radiation Therapist

Director of Nursing

Senior Radiation Therapist

Senior International SOF Engagement SME

Senior Radiation Therapist

Senior Healthcare Construction Project Manager

Traveling Senior Superintendent - Justice / Corrections

Physician

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