Job added in hotlist
Applied job
Contract job
Recruiter job
Employer job
Expanded search
Apply online not available
View more jobs in Miami, FL
View more jobs in Florida

Job Details

Data Management Specialist

Miami, FL

Apply for this job


Job Description
Kforce has a client in search of a Data Management Specialist in Miami, Florida (FL).

The incumbent serves a key role, responsible for the strategic and tactical direction of all development, staffing, planning, managing, and measuring the overall activities for the entire division related to every aspect of Adhoc Provider Authorizations and Referrals, to all types of providers. The position is responsible for developing and implementing national and regional plans that meet new and existing customer requirements, assures member access to qualified providers for authorized services, and collaborates with key leaders (CMC and Field Network) to maintain limits for budget plan/cost of care projections. This position serves as the strategic business partner to other leadership from all areas of the organization: CMC, Network Sales, Sales, Account Management, Training, and client-wide to convey process related trends and statistical data in support of each of these departments' business strategies.

Essential Job Functions:
* Establishes overall direction, plan, policy and procedural documentation for department to ensure compliance with corporate policies, customer requirements, reporting requirements, best practices and process efficiencies, related to requests for seeking, qualifying, and documenting and contracting out-of-network providers
* Ensures timely and appropriate response to all requests
* Responsible for development, modification, maintenance and review of Adhoc contracts, agreements and addenda, in conjunction with Corporate Legal Counsel, in addition to Provider Authorization and Referral policy
* Member of project team in planning and development for processes and ACES system enhancements, and engages relevant leadership from other departments, including development and delivery of training, as necessary, (i.e. Network Field, Network Services, Account Management, IT, and Care Management centers)

* High School/GED required
* 1-2 years of health care administration experience (finance/contract administration, physician/provider relations, technical writing for policy & procedural) with strong preference for managed care experience
* Credentialing experience is a major plus; The candidate will be reaching out to providers to request any credentialing documents
* Proven ability to strategically lead an organization toward the attainment of its goals and objectives, mission and values
* Microsoft Office: Word, Excel, and Access
* Excellent organizational skills required
* Excellent communication and negotiation skills
* Demonstrated team building skills to promote an environment of diversity, collaboration, and recognition
* Must have effective problem-solving skills
* Must have excellent writing skills
* Ability to handle multiple tasks at one time
* Must have the ability to be and work as a team member & provide support to team members as assigned

Preferred Skills:
Of progressively more responsible health care administration experience (finance/contract administration, physician/provider relations, technical writing for policy & procedural) with strong preference for managed care experience.

Kforce is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.

Company info

Sign Up Now -

Similar Jobs:
Grant Writer
Location : Miami, FL
Grant Writer HistoryMiami, Miami Grant Writer Scope and Objectives: Reporting to the Director of Development, this full-time position is responsible for writing proposals, completing grant applications, researching and locating fu...
Job Summary Responsible for the design and implementation and ensure the quality of standards as dictated by all the regulatory agencies for all the policies and procedures for the Urgent Care Centers. Assist with CAP and ACHA ...
Customs Entry Writers
Location : Doral, FL
Company Profile: About Albion Staffing Solutions: Albion has been offering Temp; Contract and Direct Hire Staffing Services for 20-years from offices located throughout South Florida. Offering General Admin/Clerical and Light ...
I was very pleased with the WritingCrossing. I found a great position within a short amount of time … I definitely recommend this to anyone looking for a better opportunity.
Jose M - Santa Cruz, CA
  • All we do is research jobs.
  • Our team of researchers, programmers, and analysts find you jobs from over 1,000 career pages and other sources
  • Our members get more interviews and jobs than people who use "public job boards"
Shoot for the moon. Even if you miss it, you will land among the stars.
WritingCrossing - #1 Job Aggregation and Private Job-Opening Research Service — The Most Quality Jobs Anywhere
WritingCrossing is the first job consolidation service in the employment industry to seek to include every job that exists in the world.
Copyright © 2018 WritingCrossing - All rights reserved. 169