| Location | Lakeland, FL |
Bachelor's degree in Nursing, Healthcare Administration, Business Administration, or a related healthcare, business, or analytical field, or an equivalent combination of education and experience.
Five years of experience in workers' compensation medical management, nurse case management, or a related healthcare function.
Current RN licensure or other relevant healthcare administration or workers' compensation credential, as applicable.
Experience leading people, programs, or operational teams.
Experience supporting medical care delivery, utilization management, return-to-work programs, or medical case management.
Knowledge of workers' compensation regulations, medical billing practices, fee schedules, and industry standards.
Knowledge of CPT and ICD-10 coding and medical bill review processes.
Experience using data and analytics to evaluate performance, utilization, and outcomes.
Intermediate proficiency with Microsoft Word, Excel, and PowerPoint.
Master's degree in Nursing, Healthcare Administration, Business Administration, or a related field.
Certified Case Manager (CCM), Occupational Health Certification, or multi-state RN licensure.
Experience managing multi-state workers' compensation programs, including regulatory compliance and fee schedules.
Experience overseeing clinical operations, medical bill review, and large-scale medical spend.
Experience leading multidisciplinary teams, including supervisors and indirect reports.
Experience managing external healthcare vendors, contract negotiations, and performance optimization.
Experience using analytics to evaluate provider performance, utilization trends, and medical outcomes.
Advanced Microsoft Excel skills and experience with business intelligence or analytics tools.