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    Simply Healthcare Plans (off)
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15 Jobs Found
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DRG Nurse Auditor

Job type: Full-Time

The DRG Nurse Auditor primary responsibilities include performing DRG and other inpatient coding/billing validations audits; and Utilization...

Simply Healthcare Plans  
FL - Miami
1 day ago

Concurrent Review Nurse - Dade/Broward County

Job type: Full-Time

SUMMARY: This position performs Care Coordination activities including prospective, concurrent and retrospective reviews of hospitalizations and...

Simply Healthcare Plans  
FL - Miami
1 day ago

Claims Manager - Medicare/Medicaid

Job type: Full-Time

JOB SUMMARY: The Manager of Claims will be responsible for directing and coordinating all aspects of Simply Healthcare Plans’ claims and encounters...

Simply Healthcare Plans  
FL - Miami
1 day ago

Quality Control Claims Auditor

Job type: Full-Time

Identify and validate claims processing errors and communicate findings to the appropriate departments. Identify and correct inconsistencies with...

Simply Healthcare Plans  
FL - Miami
7 days ago

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Manager of Provider Administration

Job type: Full-Time

This position will manage the day to day operations of the Provider Relations Department. This person will also be responsible for maintaining and...

Simply Healthcare Plans  
FL - Miami
8 days ago

Finance Manager (healthcare experience required)

Job type: Full-Time

General Responsibilities The Finance Manger is responsible for various accounting functions and the management of the Finance team. This position...

Simply Healthcare Plans  
FL - Miami
8 days ago

Quality Improvement Reporting Manager

Job type: Full-Time

The Quality Improvement (QI) Reporting Manager, will be responsible for the development and implementation of improvement Reporting or initiatives...

Simply Healthcare Plans  
FL - Miami
15 days ago

Bi-Lingual Member Services Representative

Job type: Full-Time

SUMMARY Interact with customers to provide information in response to inquiries received via telephone from SHP, BH, CHA and SHP-Medicare...

Simply Healthcare Plans  
FL - Miami
19 days ago

Pediatric Nurse Case Manager

Job type: Full-Time

PEDIATRIC CASE MANAGER – Pediatric Nurse , will be responsible for following the Simply Healthcare Plans CM / DM Programs and the early identification...

Simply Healthcare Plans  
FL - Miami
19 days ago

Provider Network Consultant

Job type: Full-Time

This position is responsible for, but not limited to, the development of a quality and cost effective Provider Network that will service the medical...

Simply Healthcare Plans  
FL - Tampa
21 days ago

OB Nurse Case Manager

Job type: Full-Time

SUMMARY: Completes clinical assessments on each member to determine the educational health needs. Provides and promotes self-management support...

Simply Healthcare Plans  
FL - Miami
22 days ago

Managed Care Coordinator

Job type: Full-Time

The organization is located in southeastern Florida and is headquartered in the Coral Gables area. Clear Health Alliance offers a comprehensive health...

Simply Healthcare Plans  
FL - Miami
22 days ago

Medicare STARS Data Analyst

Job type: Full-Time

Provide assistance to the Medicare STARS Program Manager in developing and maintaining reports, aquire, manage, manipulate and analyze data and report...

Simply Healthcare Plans  
FL - Miami
29 days ago

Claims Examiner (Medicare/Medicaid)

Job type: Full-Time

SUMMARY : Assure timely and accurate processing of claims and encounters, and respond to provider telephone calls, written inquiries, and appeals. The...

Simply Healthcare Plans  
FL - Miami
29 days ago

Medical Director

Job type: Full-Time

SUMMARY: The Medical Director act as a resource and an active participant in the entire scope of the Utilization, Quality and Case Management...

Simply Healthcare Plans  
FL - Tampa
29 days ago

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