Top 495 Healthcare operations Jobs in Miami Fl

Medicare Quality Accreditation Coordinator
Solis Health Plans —Doral, FL
- $25 - $30 an hour
- Weekends as needed
- Spanish
- Nursing
- Microsoft Excel
- AD&D insurance
- Health insurance
Quick Apply
5d
Director of Business Development and Operations
Cornerstone Caregiving —Homestead, FL
- From $80,000 a year
- Full-time
- Home Health
- US work authorization
- In-person
- Paid training
- Health insurance
Quick Apply
Physician Practice Manager III - Physical Med & Rehab- FT - Days - MPG
Memorial Healthcare System —Hollywood, FL
- Full-time
- Mid-level
- High school diploma or GED
- Conflict management
Supervisor, Healthcare Services
Molina Healthcare —Miami, FL
- $66,456 - $129,590 a year
- Full-time
- LMFT
- LVN
- RN License
- Health insurance
Director Physician Practice Operations, Primary Care
Baptist Health Medical Group —Coral Gables, FL
- $133,831.04 - $173,980.35 a year
- Spanish
- 7 years
- Primary Care
- Wellness program
- Health insurance
Administrative Assistant for Home Health Agency
Luna Home Care Services Inc —Kendall, FL
- $20 - $35 an hour
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Writing skills
- Paid time off
- Flexible schedule
Quick Apply
11d
Clinical Business Operations Specialist - Remote
University of Miami —Hialeah, FL
- Full-time
- Remote
- Mid-level
- 3 years
- High school diploma or GED
- Health insurance
- Dental insurance
Practice Administrator (Full Time, Days)
Nicklaus Children's Hospital —Miami, FL
- Full-time
- Microsoft Outlook
- OSHA
- 5 years
Operations Manager
LifeSpan medicine —Miami, FL
- $95,000 - $110,000 a year
- Weekends as needed
- Hybrid work
- Mid-level
- Organizational skills
- Communication skills
- Health insurance
- Dental insurance
Quick Apply
12d
Director of Campus Operations
Herzing University —Miami, FL
- $110,500 - $149,500 a year
- Classroom
- Doctoral degree
- Master's degree
- Health insurance
- Paid time off
12d
AVP of School Based Health Program
COMMUNITY HEALTH OF SOUTH FLORIDA INC —Miami, FL
- $100,000 - $135,000 a year
- School experience
- Spanish
- Nursing
Quick Apply
Director Physician Practice Operations, MNI- Office
Baptist Health Medical Group —Coral Gables, FL
- $133,831.04 - $173,980.35 a year
- Spanish
- 7 years
- English
- Wellness program
- Health insurance
2d
Case Management Assistant, Jackson Memorial Hospital, FT, Days
Jackson Health —Miami, FL
- Full-time
- High school diploma or GED
- 1 year
- Entry level
Quick Apply
9d
Practice Manager / Full-Time Employment / Coral Gables
Harmony United Psychiatric Care —Coral Gables, FL
- Full-time
- 7 years
- Psychiatry
- Pass drug screening
- Paid holidays
- Health insurance
Quick Apply
Case Management Assistant, Jackson Memorial Hospital, Days
Jackson Health —Miami, FL
- Full-time
- Acute care
- Mid-level
- High school diploma or GED
Quick Apply
9d
Manager, Administrative Operations
University of Miami —Miami, FL
- Full-time
- Microsoft Excel
- 5 years
- Office
- Health insurance
- Dental insurance
8d
Clinical Program Manager, Full Time
University of Miami —Miami, FL
- Full-time
- Mid-level
- 3 years
- Bachelor's degree
- Health insurance
- Dental insurance
Administrative Assistant - School of Nursing
University of Miami —Coral Gables, FL
- Full-time
- Nursing
- Microsoft Outlook
- Office
Case Management Assistant, Jackson Memorial Hospital, Per Diem, Days
Jackson Health —Miami, FL
- Full-time
- Mid-level
- High school diploma or GED
- 1 year
Quick Apply
Patient Access Supervisor
University of Miami —Miami, FL
- From $50,000 a year
- Full-time
- Hospital
- HIPAA
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
5d

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Medicare Quality Accreditation Coordinator

Solis Health Plans -
Doral, FL

Quick Apply

Job Details

Full-time
$25 - $30 an hour
5 days ago

Benefits

AD&D insurance
Health insurance
Dental insurance
401(k)
Flexible spending account
Paid time off
Employee assistance program
Vision insurance
401(k) matching
Life insurance
Referral program

Qualifications

Spanish
Microsoft Excel
Microsoft Office
High school diploma or GED
Health insurance knowledge
Attention to detail
Data-driven problem-solving
Associate's degree

Full Job Description

POSITION SUMMARY

The Quality and Accreditation Coordinator supports the organization's quality improvement, regulatory compliance, and NCQA accreditation activities. This role is responsible for assisting the Director of Quality Operations in coordinating quality programs, monitoring performance measures, supporting NCQA health plan accreditation surveys, maintaining required documentation, and collaborating with internal departments to ensure compliance with federal, state, and NCQA health plan accreditation standards. The coordinator assists in driving continuous quality improvement initiatives that improve member outcomes, operational performance, and health plan effectiveness.

Position is onsite Monday-Friday.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Review and analyze data across various areas, including claims, authorizations, grievances, appeals, case management, network adequacy, membership composition, and other related fields.
Assist with QOC investigation, QIC Prep, monitoring, and auditing.
Supports with preparation of evidence files and documentation for NCQA health plan accreditation surveys.
Collects reporting for measurement and benchmarking of performance measures in relation to best practices for NCQA, CMS, and internal business objectives.
Ensures data is accurate, reliable, and reported timely.
Collects performance indicator reports and benchmark narratives for review by Director of Quality Operations for performance improvement recommendations.
Assists with monitoring quality performance, outcomes, and/or metrics to make recommendations for targeted process improvement projects.
Prepares overviews and interpretation of reports; and following up on assigned action items for various projects, meetings, and committees.
Assists with accreditation and quality-related education to staff as needed.
Assists with problem analysis for strategic planning initiatives.
Solves data integrity issues as they arise, and monitor the addition of new data, analytics, and reporting systems.
Assist with interpretation and translation of data for senior management for use in meaningful decision making, and strategic planning purposes.
Assists with internal and external audits and preparation of audit responses.
Collects supporting documentation to support review of Quality-of-Care concern investigations.

QUALIFICATIONS AND EDUCATION

HS Diploma required or Associate's degree in Healthcare Administration, Nursing, or related field.
2+ years of experience in managed care, Medicare, Medicaid, or health plan setting.
Bilingual in English and Spanish.
Relevant experience may substitute for the educational requirement on a year-for-year basis.
Experience with NCQA health plan accreditation standards
Knowledge of federal regulations and industry standards.
Strong data analytical and problem-solving skills.
Excellent communication and documentation abilities.
Attention to detail with a focus on data integrity.
Experience using Microsoft applications.
Expert knowledge in Excel.

WORKING CONDITIONS

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually moderate.
Fast-paced office environment.
Highly regulated environment.
Interacts with patients, family members, staff, visitors, government agencies, etc., under a variety of conditions and circumstances.

This work requires the following physical activities: climbing, bending, stooping, kneeling, reaching, sitting, standing, walking, lifting, finger dexterity, grasping, repetitive motions, talking, hearing and visual acuity. The work is performed indoors. Sits, stands, bends, lifts, and moves intermittently during working hours. May be sitting for a prolonged period.

The work schedule is approximate, and hours/days may change based on company needs. All full-time employees are required to complete forty (40) hours per week as scheduled, including weekends and holidays as needed. May require some OT during varying seasons of the year.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

The employee must be able to frequently lift up to 10 pounds and occasionally lift and/or move up to 25 pounds. While performing the duties of this job, the employee is regularly required to talk or listen. The employee is frequently required to stand and walk. The employee is occasionally required to use hands to finger, handle, or feel; reach with hands and arms; climb or balance and stoop, kneel, crouch, or crawl. Specific vision abilities required for this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

PERFORMANCE MEASUREMENTS

Duties accomplished at the end of the day/month.
Attendance/punctuality.
Compliance with Company regulations.
Safety and Security.
Quality of work.

This Job Description may be modified at any time at the discretion of the employer as business operations may deem necessary. This does not constitute an employment agreement and may not include all duties.

The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required of personnel so classified. The incumbent must be able to work in a fast-paced environment with a demonstrated ability to juggle and prioritize multiple competing tasks and demands and to seek supervisory assistance as appropriate.

Pay: $25.00 - $30.00 per hour

Benefits:

401(k)
401(k) matching
AD&D insurance
Dental insurance
Employee assistance program
Flexible spending account
Health insurance
Life insurance
Paid time off
Referral program
Vision insurance

Work Location: In person

Quick Apply

Refine Your Search

healthcare operations jobs in miami fl

Medicare Quality Accreditation Coordinator

Director of Business Development and Operations

Physician Practice Manager III - Physical Med & Rehab- FT - Days - MPG

Supervisor, Healthcare Services

Director Physician Practice Operations, Primary Care

Administrative Assistant for Home Health Agency

Clinical Business Operations Specialist - Remote

Practice Administrator (Full Time, Days)

Operations Manager

Director of Campus Operations

AVP of School Based Health Program

Director Physician Practice Operations, MNI- Office

Case Management Assistant, Jackson Memorial Hospital, FT, Days

Practice Manager / Full-Time Employment / Coral Gables

Case Management Assistant, Jackson Memorial Hospital, Days

Manager, Administrative Operations

Clinical Program Manager, Full Time

Administrative Assistant - School of Nursing

Case Management Assistant, Jackson Memorial Hospital, Per Diem, Days

Patient Access Supervisor

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