Sunshine State Health Plan jobs in Sunrise, FL

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Utilization Specialty Therapist
3+ years of experience providing therapy services in healthcare or home health settings. Current state license in Physical Therapy, Occupational Therapy or...
Clinical Appeals Coordinator
Maintain current knowledge of NCQA and State regulations. 3+ years of experience providing therapy services in healthcare or home health settings....
Care Manager II (Field-Based)
Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment...

Community Health Services Representative I

Sunrise, FL
Coordinate and implement community events such as baby showers, health fairs, and other health education events....

Quality Specialist I (Call Center)

Sunrise, FL
Perform quality review to ensure a high level of customer service Perform quality check and audits of inbound and outbound calls to ensure adherence to...

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...

Special Investigation Unit Investigator

Sunrise, FL
Provide case updates on progress of investigations and coordinate with Health Plans on recommendations and further actions and/or resolutions....

Enrollment Processor I

Sunrise, FL
Oversee data integrity of member enrollment records and remittance files transmitted from the state. Responsible for maintaining internal computer systems...

Lead Enrollment Processor

Sunrise, FL
Review and ensure all policy and procedural documentation is complete and updated timely, attend state, internal and corporate meetings as requested, and train...

Assistant Director of Athletic Communications

Boca Raton, FL 33431
Lynn University, a NCAA Division II member and a member of the Sunshine State Conference, is accepting applications for the position of Assistant Director of...
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Supervisor, Program Coordination

Sunrise, FL
Develop plan specific literature and educational components for member and provider distribution. Perform collaborative duties for the development and...

Quality Improvement Analyst.

Sunrise, FL
Develop and update quarterly, annual and ad hoc reports including analysis and narrative for NCQA accreditation and Health Plan deliverables....

Compliance Specialist

Sunrise, FL
Oversee the day-to-day health plan policies and procedures to ensure federal and state regulatory compliance. Develop and update plan policies and procedures to...
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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