Top 39 Director of claims Jobs in Tampa, Fl

Director, Actuarial Services
Avalon Administrative Services LLC —Tampa, FL
- Full-time
- 5 years
- HIPAA
- Office
- Health insurance
4d
Director of Nursing
Riverside Care of Florida, LLC —Brandon, FL
- $40 - $42 an hour
- Full-time
- Background check
- Nursing
- RN License
- Health insurance
Quick Apply
4d
Regional Director of Operations
Women's Care —Tampa, FL
- Full-time
- Computer literacy
- HIPAA
- Microsoft Office
- Paid holidays
- Dental insurance
Quick Apply
7d
Director of Claims
Slide Insurance —Tampa, FL
- Microsoft Excel
- Microsoft Outlook
- Bachelor's degree
- Health insurance
Quick Apply
Director of Training & Operations Support
College Hunks Hauling Junk and Moving - Corp Office —Tampa, FL
- Full-time
- Hybrid work
- 7 years
- Public speaking
- Education
- Health insurance
- Dental insurance
Quick Apply
Senior Regional Director of Human Resources- South to Central Florida
VITAS Healthcare —Tampa, FL
- Full-time
- Up to 50% travel
- Travel
- Experience equivalent to degree accepted
- Disability insurance
- Health insurance
Quick Apply
Program Director - Home Health Coordinator Planning Office (Florida Health Plan) - Remote in Florida
Molina Healthcare —Tampa, FL
- $80,412.00 - $156,803.45 a year
- Full-time
- Remote
- 3 years
- Finance
- Master's degree
- Health insurance
Senior Director of Revenue Cycle
Florida Orthopaedic Institute —Tampa, FL
- Pass drug screening
- HIPAA
- Bachelor's degree
Quick Apply
Director of Finance, Risk & Compliance
DGR Systems —Tampa, FL
- $150,000 - $175,000 a year
- Full-time
- Hybrid work
- Office
- US work authorization
- Senior level
- Health insurance
- Paid time off
Quick Apply
4d
Arts Director
Hillsborough College —Tampa, FL
- $84,569.43 - $93,026.37 a year
- Full-time
- Inventory management
- Mid-level
- 3 years
Operations Director (Cardiology) Tampa Area
Cardiovascular Associates of America —Tampa, FL
- $130,000 - $185,000 a year
- Full-time
- Microsoft Outlook
- HIPAA
- Bachelor's degree
Quick Apply
Human Resources Director
CITY OF MADEIRA BEACH —Madeira Beach, FL
- $90,000 - $125,000 a year
- Weekends as needed
- Computer literacy
- Writing skills
- Office
- Dental insurance
Director of Operations
AFC Companies —Tampa, FL
- 7 years
- Senior level
- Leadership
Quick Apply
Director of Security and Safety
Marriott International, Inc —Clearwater Beach, FL
- $79,000 - $105,000 a year
- Full-time
- CPR Certification
- Mid-level
- Hotel
1d
Self-Funded Director, Claims
Amwins —Tampa, FL
- Hybrid work
- Microsoft Outlook
- HIPAA
- Office
- Paid holidays
- Paid time off
Quick Apply
Director, Provider Network & Analytics
Avalon Administrative Services LLC —Tampa, FL
- Full-time
- Remote
- Analysis skills
- Travel
- Senior level
- Health insurance
Director of Safety and Risk Management
College Hunks Hauling Junk and Moving - Corp Office —Tampa, FL
- Full-time
- Hybrid work
- 5 years
- Computer literacy
- Office
- Health insurance
- Dental insurance
Quick Apply
Managing Director, Turnaround & Restructuring Services
Portage Point Partners —Tampa, FL
- $925,000 - $2,000,000 a year
- Hybrid work
- Office
- Analysis skills
- Bachelor's degree
Quick Apply
Director, Turnaround & Restructuring Services
Portage Point Partners —Tampa, FL
- $650,000 - $900,000 a year
- Hybrid work
- Office
- Bachelor's degree
- Mentoring
Quick Apply
Director, Employee Benefits Financial Strategy
IMA Financial Group —Saint Petersburg, FL
- $200,000 - $225,000 a year
- Writing skills
- Office
- Analysis skills
- Health savings account
- AD&D insurance
Quick Apply
12d

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director of claims jobs near tampa, fl

Director, Actuarial Services

Avalon Administrative Services LLC
Tampa, FL

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Job Details

Full-time
4 days ago

Benefits

Health insurance

Qualifications

Affordable Care Act (ACA)
Data visualization software proficiency
Medicare
ASA
Managed care organization experience
CMS
ICD-10
CMS regulatory compliance
HCPCS
Bachelor's degree
Health insurance knowledge
Medicare regulations
Medicaid

Full Job Description

About Avalon Healthcare Solutions:

Avalon Healthcare Solutions is the nation’s leader in diagnostic intelligence, uniquely focused on transforming the role of diagnostic testing across the healthcare ecosystem. Our proprietary Diagnostic Insights Platform delivers evidence-based policies, curated lab networks, and real-time analytics that simplify complex diagnostics, accelerate innovation adoption, and optimize diagnostic investments.

Supporting over 30 health plans and 100 million members nationwide, Avalon partners with payers and providers to ensure diagnostic testing is performed appropriately, efficiently, and at the right time. Our flexible solutions span routine and genetic testing management, automated adherence, and end-to-end diagnostics support—driving measurable value, reduced waste, and improved clinical outcomes.

With unmatched scientific rigor, deep clinical expertise, and a performance-based model, Avalon is redefining how diagnostics power personalized care and healthcare value. You will be part of a team that shapes a new market and business. Most importantly, you will help Avalon to achieve its mission and improve clinical outcomes and health care affordability for the people we serve.

For more information about Avalon, please visit www.avalonhcs.com

Avalon Healthcare Solutions is an Equal Opportunity Employer - Vet/Disability.

This position description is subject to change at any time. As determined by the company based upon business needs, an employee in this position may be required to perform duties and take responsibility for work other than as described in this document.

About the Director, Actuarial Services Position:

The Director, Actuarial Services is responsible for leading the organization's actuarial and healthcare analytics functions in support of strategic, financial, and operational objectives. This role directs the development and maintenance of actuarial models, financial forecasts, reserving methodologies, and risk analyses that support business performance and informed decision-making. Leveraging deep actuarial expertise and healthcare industry knowledge, the Director evaluates emerging trends, utilization patterns, medical cost drivers, and financial risks to provide actionable insights and recommendations.

The Director, Actuarial Services partners closely with executive leadership and cross-functional stakeholders, including Finance, Health Analytics, Network Management, and Product teams, to support pricing strategies, financial forecasting, risk adjustment initiatives, and regulatory compliance. This position is responsible for communicating actuarial findings, financial risk exposure, and strategic recommendations to leadership while driving continuous improvement of actuarial methodologies, tools, data infrastructure, and reporting capabilities. Through the application of advanced analytics and actuarial principles, the Director supports organizational performance, financial sustainability, and data-driven decision-making.

This position is eligible for remote work, but quarterly travel will be required to Avalon's corporate office located in Tampa, Florida.

Director, Actuarial Services – Essential Functions and Responsibilities:

Direct the development and maintenance of actuarial models for all lines of businesses and products
Monitor program performance, researching reasons for variances and providing/implementing actionable plans
Oversee medical cost trend analysis, utilization reviews, and per-member-per-month (PMPM) projections
Own the reserving process, including incurred but not reported (IBNR) liability estimates, claims development triangles, and variance analyses
Ensure actuarial compliance with state and federal regulatory requirements
Partner with finance, health analytics, network management, and product teams to support pricing strategy and financial forecasting
Serve as the primary actuarial liaison with internal and external auditors
Direct the development of risk adjustment strategies and analytics
Provide executive leadership with clear, concise communication of actuarial findings, financial risk exposure, and strategic recommendations
Drive continuous improvement of actuarial models, tools, data infrastructure, and team workflows
Monitor industry trends, regulatory changes, and emerging healthcare cost drivers and communicate implications to leadership
Lead ad hoc analyses and deep dives as required.

Director, Actuarial Services – Minimum Qualifications:

Bachelor's degree in Actuarial Science, Mathematics, Statistics, or a related quantitative field
Associate of the Society of Actuaries (ASA) designation is required at minimum
Member in good standing with the American Academy of Actuaries (MAAA) required
5+ years of actuarial experience, with at least 5 years in a health plan or managed care setting
Demonstrated expertise in healthcare actuarial pricing, reserving, or risk adjustment
Strong proficiency in actuarial and analytical tools (e.g., Excel/VBA, Tableau, SAS, R, Python, or similar)
Deep understanding of ACA regulations, CMS programs (Medicare Advantage, Medicaid)
Exceptional communication and presentation skills with the ability to convey complex actuarial concepts to non-actuarial executives and board members
Understanding of medical coding systems (ICD-10, CPT, HCPCS, DRG)
Strong analytical, critical thinking, and problem-solving skills
Excellent written and verbal communication skills

Director, Actuarial Services – Preferred Qualifications:

10+ years of actuarial experience in health insurance, managed care environment
Experience with risk adjustment and risk transfer
Exposure to predictive modeling, machine learning applications in actuarial contexts, or health risk scoring
Experience working with large-scale data platforms (Snowflake, Databricks, AWS)
Experience with Tableau, Python or R for statistical analysis
Knowledge of value-based care models (ACOs, PCMH, bundled payments)
Understanding of HIPAA regulations and healthcare data governance practices

PM18

PI96a9f01bbcb4-25404-41268727

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Refine Your Search

director of claims jobs in tampa, fl

Director, Actuarial Services

Director of Nursing

Regional Director of Operations

Director of Claims

Director of Training & Operations Support

Senior Regional Director of Human Resources- South to Central Florida

Program Director - Home Health Coordinator Planning Office (Florida Health Plan) - Remote in Florida

Senior Director of Revenue Cycle

Director of Finance, Risk & Compliance

Arts Director

Operations Director (Cardiology) Tampa Area

Human Resources Director

Director of Operations

Director of Security and Safety

Self-Funded Director, Claims

Director, Provider Network & Analytics

Director of Safety and Risk Management

Managing Director, Turnaround & Restructuring Services

Director, Turnaround & Restructuring Services

Director, Employee Benefits Financial Strategy

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