Healthcare business analyst • miramar fl
Provide comprehensive healthcare management services to facilitate appropriate healthcare treatment, effectively manage healthcare costs and improve healthcare program/operational efficiency involv... Show more
Responsible for developing, formalizing, and documenting operational processes while implementing controls to ensure adherence to internal policies and regulatory requirements.Serves as the primary... Show more
COURSER is a partnership platform that helps technology service companies identify and take the next step in growth.Our organization has a strong company culture built on our values of Teamwork, Se... Show more
Responsible for developing, formalizing, and documenting operational processes while implementing controls to ensure adherence to internal policies and regulatory requirements.Serves as the primary... Show more
Bilingual Healthcare Consultant-{171482} Location: Hialeah, FL.MUST live in one of these zip codes: 33010, 33002, 33011, 33012, 33013, 33014, 33015, 33016, 33017, 33018 · Travel: 50% to 75% local t... Show more
Investment Strategy & Advisory.Predictive Analytics & Visualization.AI data lab for training frontier models and evaluating AI agents.Experts contribute their diverse subject matter knowled... Show more
Must have 2+ years of financial related experience.Please note: If this position is posted as either fully remote and/or hybrid, in accordance with company policy, individuals residing within a 50-... Show more
Investment Strategy & Advisory.Predictive Analytics & Visualization.AI data lab for training frontier models and evaluating AI agents.Experts contribute their diverse subject matter knowled... Show more
The Benefits Accounting Analyst will be responsible for the accounting and administration of all benefits plans.This role will be responsible for all accounting, analytical and reporting tasks rela... Show more
About Mercor’s talent network** Join our Business Intelligence Analyst Expert Network to connect with leading AI labs and companies seeking your expertise.This is an open application for future con... Show more
CAI is a global services firm with over 9,000 associates worldwide and a yearly revenue of $1.We have over 40 years of excellence in uniting talent and technology to power the possible for our clie... Show more
Investment Strategy & Advisory.Predictive Analytics & Visualization.AI data lab for training frontier models and evaluating AI agents.Experts contribute their diverse subject matter knowled... Show more
This is a hybrid position in Miami Lakes.The EPMO Business Analyst II is a key contributor within the Enterprise Project Management Office, responsible for supporting the early phases of the Projec... Show more
About Mercor’s talent network** Join our Business Intelligence Analyst Expert Network to connect with leading AI labs and companies seeking your expertise.This is an open application for future con... Show more
Note : This is an educational program, not a job.Successful completion of the program does not guarantee employment but will equip you with valuable skills for the healthcare job market.Looking to ... Show more
Investment Strategy & Advisory.Predictive Analytics & Visualization.AI data lab for training frontier models and evaluating AI agents.Experts contribute their diverse subject matter knowled... Show more
Job Summary (Benefits Analyst Fort Lauderdale, FL):</b><br /> <br /> - Support administration of employee benefits and retirement (401k) programs<br /> - Perform audits ... Show more
We are an equal-opportunity employer.All applicants will be considered without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sex... Show more
Investment Strategy & Advisory.Predictive Analytics & Visualization.AI data lab for training frontier models and evaluating AI agents.Experts contribute their diverse subject matter knowled... Show more
The average salary range is between $ 75,009 and $ 126,220 year , with the average salary hovering around $ 95,439 year .
Provide comprehensive healthcare management services to facilitate appropriate healthcare treatment, effectively manage healthcare costs and improve healthcare program/operational efficiency involving clinical issues. Determines medical necessity/appropriateness Facilitates optimal outcomes Identifies and follow through with continuous quality/compliance opportunities. May also include identification of aberrance's and initiation of corrective action Educates/empowers customers to ensure compliance, satisfaction and promote patient advocacy Optimize total costs Implementation and evaluation of policy based on usage and program directives Educate/empower colleagues at all levels to enable decision making at most appropriate level.
Coordinates case management activities for Medicaid Long Term Care/Comprehensive Program enrollees. Utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management tools and resources. Conducts comprehensive evaluation of Members using care management tools and information/data review. Coordinates and implements assigned care plan activities and monitors care plan progress. Conducts multidisciplinary review to achieve optimal outcomes. Identifies and escalates quality of care issues through established channels. Utilizes negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs. Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health. Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices. Helps member actively and knowledgeably participate with their provider in healthcare decision-making. Monitoring, Evaluation and Documentation of Care: Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
Case management experience required. Long term care experience preferred. Microsoft Office including Excel competent. Location: Work from Home. Candidates must reside in Miami Dade County, FL. Training will be conducted remotely via WebEx for approximately 1-2 weeks. Candidate will travel approximately 75% of the time within the region seeing Members at home, in assisted living facilities and nursing homes.
Bilingual Spanish/English Ability to multitask, prioritize and effectively adapt to a fast paced changing environment Effective communication skills, both verbal and written.
Bachelor's degree required - No Nurses. Social work degree or related field. Minimum 1 year of relevant experience in case management. Social work, Case management, Spanish.
