Talent.com

Provider Jobs in Miami, FL

Create a job alert for this search

Provider • miami fl

Last updated: 2 days ago

Senior Specialist, Provider Network Administration (Salesforce)

Molina HealthcareMiami, FL, United States
Full-time

Provider Network Administration.Provider Network Administration is responsible for the accurate and timely validation, analysis, maintenance, and governance of critical provider information across ... Show more

Float Clinical Partner, Float Pool-Healthcare Provider, $3000 Bonus, FT, 07A-7:30P

Baptist Hospital of MiamiMiami
$17.79 hourly
Full-time

Baptist Health is the region's largest not-for-profit healthcare organization, with 12 hospitals, over 29,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and phys... Show more

Certified Registered Nurse Anesthetist (CRNA) - Anesthesiology - General/Other in Florida

LocumJobsOnlineMiami, Florida, US
Full-time +1

Certified Registered Nurse Anesthetist | Anesthesiology - General/Other.Competitive weekly pay (inquire for details) .LocumJobsOnline is working with KPG Healthcare to find a qualified Anesthesiolo... Show more

Float Clinical Partner, Float Pool-Healthcare Provider, $3000 Bonus, FT, 07A-7:30P

Baptist HealthMiami, FL, United States
$17.79 hourly
Full-time

The Clinical Partner II (CP) is a staff position responsible for providing basic technical nursing care skills under the direction and supervision of the Registered Nurse (RN).The CP is a valued me... Show more

Advanced Practice Provider (APRN/PA-C) Acute, BHMG Interventional Radiology, FT, 9A-7:30P

Baptist Health Medical GroupMiami
Full-time

Baptist Health is the region's largest not-for-profit healthcare organization, with 12 hospitals, over 29,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and phys... Show more

Physician Performance Representative

Genuine Health GroupMiami, FL, United States
Full-time

Provider Relations Representative.The Provider Relations Representative role requires frequent travel throughout their assigned areas.This high-impact role serves as a key liaison between Genuine H... Show more

Provider Relations Representative

Doctors Healthcare PlansMiami, FL, United States
Full-time

Provider Relations Representative.Exercise the duties and responsibilities delegated to the Provider Relations Representative with the outmost professionalism and dedication.Responsible for conduct... Show more

Remote Healthcare Administrative Specialist - AI Trainer ($40-$50 per hour)

MercorHialeah, Florida, US
$40.00 hourly
Remote
Full-time

About the Role** We're looking for professionals with deep, hands-on experience in the administrative and operational work that keeps healthcare organizations running — the "back office" of a medic... Show more

Early Steps Community Provider Recruitment and Training Coordinator

University of MiamiMiami, FL, United States
Full-time

Early Steps Community Provider Recruitment And Training Coordinator.The University of Miami Health System, "UHealth", Department of Pediatrics has an exciting opportunity for a Full-Time Early Step... Show more

Housekeeper Wanted - Housekeeping Service Provider Wanted In Downtown Miami

Housekeeper.comMiami, Florida, USA
Full-time

Looking for a housekeeper and laundry every 2-3 weeks around 5-6 hours per session.Downtown miami Please visit https://housekeeper. Show more

Network Data Specialist- Credentialing Team

FLORIDA DOCTORS GROUP CORPcoral gables, FL, US
$19.00 hourly
Full-time

Join Our Growing Healthcare Team!.Are you a highly organized, detail-oriented professional who enjoys working with data, healthcare operations, and provider relations? Florida Doctors Group is look... Show more

Director, Provider Relations

Independent Living Systems, LLCMiami, FL, United States
Full-time

We are seeking a Director, Provider Relations to join our team at Independent Living Systems (ILS).ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete C... Show more

Provider Enrollment Specialist (Credentialing)

KIDZ Medical ServicesMiami, FL, United States
Full-time

Seeking a full-time credentialing specialist to join our large pediatric multi-specialty practice.Flexible work hours available with the possibility of a hybrid schedule after 3 months.Summary: Coo... Show more

Sr. Provider Relations Representative

ClareMedica Health PartnersHialeah, FL, United States
Full-time

Provider Relations Representative.Miami Lakes, FL 33016; Miami, FL 33126.At Claremedica, exceptional is the standard.Driven by our purpose to enhance the lives of the seniors in the communities whe... Show more

Provider Relations Representative

DOCTORS HEALTHCARE PLANS, INC.Coral Gables, FL, US
Full-time
Quick Apply

Exercise the duties and responsibilities delegated to the Provider Relations Representative with the outmost professionalism and dedication.Responsible for conducting provider orientations of newly... Show more

Provider Contract Configuration Specialist

Doctors Healthcare Plans, Inc.Miami, FL, United States
Full-time

Configuration and maintenance of provider contracts and benefits.Configure and load provider contracts.Maintain Provider Directory data.Test provider contract and fee-schedules.Review provider data... Show more

Elder Care Provider

ElderCare.comHialeah, Florida, USA

Buscando un acompañante de tiempo parcial (part-time) para una pareja de ancianos en Hialeah, Florida.Se prefiere alguien que viva en el lugar con renta reducida en una eficiencia separada que cuen... Show more

Provider Partnerships Manager (Territory Sales Manager)Miami, FL

NourishMiami, FL, United States
Full-time

Provider Partnerships Manager (Territory Sales Manager).As a Provider Partnerships Manager, you'll be instrumental in advancing our mission to enhance health outcomes for as many patients as possib... Show more

Supervisor Advanced Practice Provider, Oncology - Outpatient, FT, 8:30A-5P

Baptist Health Herbert Wertheim Cancer InstituteMiami
$137,846.34 yearly
Full-time

Baptist Health is the region's largest not-for-profit healthcare organization, with 12 hospitals, over 29,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and phys... Show more

Cardiology Physician

KPG Provider ServicesMiami Beach, Florida, US
Full-time +1

Cardiology physician job in Florida : KPG Provider Services is a nationwide healthcare agency specializing in connecting qualified clinicians with premier healthcare facilities.We are currently see... Show more

Senior Specialist, Provider Network Administration (Salesforce)

Senior Specialist, Provider Network Administration (Salesforce)

Molina HealthcareMiami, FL, United States
30+ days ago
Job type
  • Full-time
Job description

Provider Network Administration

Provider Network Administration is responsible for the accurate and timely validation, analysis, maintenance, and governance of critical provider information across claims, credentialing, contracting, and provider network systems. This role serves as a hybrid position focused on supporting provider lifecycle management operations through data analysis, reporting, workflow optimization, system enhancements, and cross-functional coordination.

The role partners closely with Network Operations, IT, PMO, Product Owners, Compliance, and business stakeholders to support operational initiatives, identify process improvement opportunities, enhance reporting capabilities, and improve provider data quality and operational performance.

Essential Job Duties

  • Assists in requirement gathering, providing solutions, training users in Salesforce, creating training manuals.
  • Generates and prepares provider-related data and reports, and ensures provider information in applicable computer system(s) is accurate.
  • Provides timely, accurate generation and distribution of required reports that support continuous quality improvement of the provider database, compliance with regulatory/accreditation requirements, and provider network administration business operations.
  • Generates other provider-related reports, such as: claims report extractions; regularly scheduled reports related to network management (ER, network access fee, etc.); and mailing label extract generation.
  • Reviews/analyzes data by applying job knowledge to ensure appropriate information has been provided.
  • Maintains department quality standards for provider demographic data with affiliation and fee schedule attachment.
  • Ensures accurate entries of information into health plan systems.
  • Audits loaded provider records for quality and financial accuracy, and provides documented feedback.
  • Develops and maintains documentation and guidelines for all assigned areas of responsibility.
  • Assists in resolution of configuration issues with applicable teams.
  • Provides support for provider network administration projects.
  • Provides training and support to new and existing provider network administration team members.

Required Qualifications

  • At least 4 years of health care experience, to include experience in claims, provider services, provider network operations, and/or hospital/physician billing, or equivalent combination of relevant education and experience.
  • Claims processing experience, including coordination of benefits, subrogation, and/or eligibility criteria.
  • Experience with medical terminology, Current Procedural Terminology (CPT), International Classification of Disease (ICD-9/ICD-10) codes.
  • Attention to detail, and ability to facilitate accurate data entry/review.
  • Data entry/processing skills.
  • Customer service skills.
  • Ability to manage multiple priorities and meet deadlines.
  • Effective verbal and written communication skills.
  • Microsoft Office suite (including intermediate Excel skills) and applicable software programs proficiency.

Preferred Qualifications

  • Salesforce
  • Intermediate to Advanced Excel
  • QNXT
  • Managed Care background

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V