Sunshine State Health Plan jobs in Sunrise, FL

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Long Term Care Coordinator I (Southern Palm Beach County)
Home health, discharge planning, or long term care experience preferred. Collaborate with discharge planners, physicians, and other parties to ensure...
Supervisor, Clinical
Experience in a psychiatric health care setting, including familiarity with mental health community resources....
RN / Intensive Care Unit
401(k) Retirement Plan. The Sunshine State will provide you with an amazing tropical experience that you will always remember....

Program Coordinator I

Sunrise, FL
Attend marketing and outreach meetings as directed to represent the plan. Perform transition of care duties to include but not limited to, contact the member’s...

Quality Improvement Coordinator I

Sunrise, FL
Perform duties and functions to comply with quality improvement programs according to state requirements. Audit medical records and monitor performance measures...

Data Scientist I

Sunrise, FL
Responsible for advanced and predictive data analytics using big data and data science technology for healthcare innovation. Perform analysis using data...

Data Analyst IV

Sunrise, FL
Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis....

Contract Implementation Analyst

Sunrise, FL
Review new and current provider contracts and established state guidelines. Participate in determining the appropriate configuration of the claims payment...

Supervisor, Enrollment

Sunrise, FL
Respond to state complaints regarding member eligibility and enrollment records or provide information to respond to those issues....

Director, Quality Improvement

Sunrise, FL
Certified Professional in Health Care Quality preferred. Oversee provider satisfaction surveys and implement action plans for improvements....

Supervisor, Referral Services

Sunrise, FL
Reconcile pended claim issues in a timely manner per health plan/department procedure. Review and process denial letters, maintain logs, and coordinate...

Chief Operating Officer

Sunrise, FL
Ensure successful development and implementation of business plans. Provide management all necessary contractual requirement information regarding state and...

Vice President, Quality Improvement

Sunrise, FL
RN license and Certified Professional in Health Care Quality preferred. Oversee the business processes related to risk adjustment and quality improvement for...
Concurrent Review Nurse II (RN) *Field based
Position Purpose: Promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and...
Vice President, Medical Management
Current state nursing license. Perform duties to direct and coordinate the medical management, quality improvement and credentialing functions for the assigned...
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