Top 247 Claims manager Jobs in Orlando Fl

Manager of Provider Network Central Florida
Solis Health Plans —Orlando, FL
- $100,000 - $120,000 a year
- Weekends as needed
- Ability to walk for extended periods
- 3 years
- Master's degree
- Health insurance
- Dental insurance
Quick Apply
Customer Care Manager - State Farm Agent Team Member
Heather Thies - State Farm Agent —Clermont, FL
- $50,000 - $75,000 a year
- Full-time
- Mid-level
- Office
- Administrative experience
- Health insurance
- Dental insurance
Quick Apply
Medical Billing Manager
Growing Together Pediatrics —Ocoee, FL
- From $28 an hour
- Full-time
- Hybrid work
- Background check
- Customer service
- HIPAA
- Health insurance
- Flexible spending account
Quick Apply
7d
Contract Negotiation Manager (Florida)
CVS Health —Florida
- $60,300 - $132,600 a year
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- 3 years
- Health insurance
- Dental insurance
10d
Field Reimbursement Manager- Orlando, FL
Amgen —Orlando, FL
- $145,470.70 - $196,813.30 a year
- Hybrid work
- Clean driving record
- Doctoral degree
- Computer literacy
- Disability insurance
- Health insurance
14d
Manager, Claims Workers Compensation
AmTrust Financial Services, Inc. —Maitland, FL
- Full-time
- Sales
- Bachelor of Science
- Mid-level
- Health insurance
- Dental insurance
1d
Claims Operations Director/Manager
CNA Insurance —Lake Mary, FL
- $97,000 - $189,000 a year
- Full-time
- Hybrid work
- 5 years
- Analysis skills
- Organizational skills
Property Manager
Avenue5 Residential, LLC —Orlando, FL
- $75,000 - $77,000 a year
- Full-time
- Clean driving record
- Microsoft Excel
- Microsoft Outlook
- Paid holidays
- Health insurance
Quick Apply
7d
Claims Training Manager
Frontline Insurance Managers Inc. —Lake Mary, FL
- Extended hours
- Customer service
- 11+ years
- Mid-level
- Disability insurance
- Health insurance
Quick Apply
Manager, Transportation
Freshpoint —Orlando, FL
- Weekends as needed
- 18 years or older
- Computer literacy
- Basic math
3d
Risk & Quality Performance Manager (Remote)
Molina Healthcare —Orlando, FL
- $66,456 - $129,590 a year
- Full-time
- Remote
- Microsoft Excel
- Azure
- Mid-level
- Health insurance
FL-Orlando Sales Manager Trainee (HEAR FROM OUR AGENTS!)
AMERICAN SENIOR BENEFITS LLC —Orlando, FL
- $50,000 - $100,000 a year
- Full-time
- Management
- Recruiting
- Leadership
Territory Manager - Orlando Southeast
Zoll Medical Corporation —Orlando, FL
- $100,000 - $175,000 a year
- Weekends as needed
- Hospital
- 3 years
- Clinic
Leave Administrator Lead
(Mosaic Shared Services) Millennium Healthcare Management Serv LLC —Oviedo, FL
- $70,379 - $105,569 a year
- Full-time
- 3 years
- Analysis skills
- Bachelor's degree
- Military leave
Quick Apply
3d
Associate Client Manager
Gallagher —Lake Mary, FL
- Full-time
- Mid-level
- High school diploma or GED
- Bachelor's degree
- Paid parental leave
- Health savings account
Client Service Manager
Gallagher —Lake Mary, FL
- Full-time
- Sales
- Mid-level
- 3 years
- Paid parental leave
- Health savings account
10d
Risk Manager
Automotive Services Network —Winter Park, FL
- $80,000 - $100,000 a year
- Weekends as needed
- Clean driving record
- 5 years
- Pass drug screening
- Health insurance
- Dental insurance
Quick Apply
Key Accounts Program Manager- Workers’ Compensation – Transportation
Insurance Office of America, Inc. —Winter Park, FL
- $95,000 - $135,000 a year
- Full-time
- Office
- 3 years
- Finance
- Paid holidays
- Health insurance
Quick Apply
Technical Product Manager, Production Support
Healthfirst —Lake Mary, FL
- $119,600 - $194,480 a year
- Full-time
- Computer Science
- SQL
- Supervising experience
- Health insurance
- Dental insurance
Total Loss Associate Manager
Tesla —Orlando, FL
- Full-time
- 5 years
- Recruiting
- Senior level
- Commuter assistance
- Health savings account
1h

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claims manager jobs near orlando fl

Manager of Provider Network Central Florida

Solis Health Plans -
Orlando, FL

Quick Apply

Job Details

Full-time
$100,000 - $120,000 a year

Benefits

Health insurance
Dental insurance
Paid time off
Vision insurance
401(k) matching

Qualifications

Staff supervision
Teamwork
Team supervision
Managed care organization experience
Contract management experience in healthcare
Master's degree
Bachelor's degree
Contracts
Financial management
General management
Negotiation

Full Job Description

POSITION SUMMARY

The Manger of Network Central Florida directs and develops a healthcare provider network. Designs and administer policies and services that comply with all contractual and regulatory requirements. Develops, executes, and maintains a provider network strategy. Works in concert with medical management and sales to develop strategies to meet market growth and medical cost targets. Provides service and education to network physicians/providers.

ESSENTIAL DUTIES AND RESPONSIBILITIES

To perform this job, an individual must perform each essential function satisfactorily, with or without reasonable accommodation, including, but not limited to:

Key Responsibilities

Serves as a communication link between providers and the company.
Serves as a business unit representative on enterprise initiatives around network management and leads projects with significant impact.
Leads a team of department managers in developing and executing strategic departmental initiatives.
Monitors primary care and specialty risk arrangements for Medicaid and Medicare product lines.
Performs data analysis and develops specific actions to manage medical cost trends.
Develops best practice to assist risk partners in managing financial risk.
May work on projects impacting the business unit requiring collaboration with other key areas or serve on enterprise projects around network management.
Identifies areas to improve provider service levels.
Educates/enhances relationships within the provider community.
Manages Network integrity and compliance.
Manages claims projects as necessary/required.
Manages provider loads as necessary/required.
Special projects as assigned or directed.
Prepares financial projections and conducts analysis.

SUPERVISORY RESPONSIBILITY

Yes.

QUALIFICATIONS AND EDUCATION

Required Qualifications

Requires a Bachelor's Degree in Business, Healthcare or related field.
Preferred A Master's Degree in a related field.
Candidate Experience Required:
7 years of experience in the healthcare sector (preferably at HMO or PPO).
5 years of experience in HMO provider/hospital/ancillary contracting and network development.
3 years of management experience.

Preferred Qualifications

Intermediate Demonstrated leadership skills Disciplined, hands-on and process-oriented leader.
Advanced Other Knowledge of regulatory requirements concerning Medicare and Medicaid.
Advanced Other Knowledge of provider contracts and health care reimbursement.
Intermediate Other Understanding of regulatory compliance management and reporting requirements.
Ability to manage complex transactions and service models.
Demonstrated proficiency in establishing and driving medical cost management programs.
Ability to negotiate effectively with internal/external stakeholders, large hospital and physician healthcare systems.

WORKING CONDITIONS

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

The noise level in the work environment is usually moderate.
Works in the field
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 hear. 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.

Employee Acknowledgement:

I have read this job description and understand what is expected of me while I occupy this role.

Pay: $100,000.00 - $120,000.00 per year

Benefits:

401(k) matching
Dental insurance
Health insurance
Paid time off
Vision insurance

Work Location: In person

Quick Apply

Refine Your Search

claims manager jobs in orlando fl

Manager of Provider Network Central Florida

Customer Care Manager - State Farm Agent Team Member

Medical Billing Manager

Contract Negotiation Manager (Florida)

Field Reimbursement Manager- Orlando, FL

Manager, Claims Workers Compensation

Claims Operations Director/Manager

Property Manager

Claims Training Manager

Manager, Transportation

Risk & Quality Performance Manager (Remote)

FL-Orlando Sales Manager Trainee (HEAR FROM OUR AGENTS!)

Territory Manager - Orlando Southeast

Leave Administrator Lead

Associate Client Manager

Client Service Manager

Risk Manager

Key Accounts Program Manager- Workers’ Compensation – Transportation

Technical Product Manager, Production Support

Total Loss Associate Manager

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