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Remote Prominence Health Plan Jobs in Florida (NOW HIRING)

$108K - $190K/yr

Remote Senior Strategy Manager Summary: Build your Career. Make a Difference. Presbyterian is ... system, and health plan. * Translate complex analyses into well structured, mistake free ...

$100K - $175K/yr

Remote Solutions Architect Summary: Build your Career. Make a Difference. Presbyterian is hiring a ... Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid ...

$57K - $97K/yr

Remote Accountant Summary: Build your Career. Make a Difference. Presbyterian is hiring a skilled ... Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid ...

$100K - $175K/yr

Remote Expert EPIC Configuration Analyst (Willow) Summary: Build Your Career. Make a Difference. We ... Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid ...

New

$81K - $138K/yr

Remote Senior EPIC Configuration Analyst (Healthy Planet and Compass Rose) Summary: Build Your ... Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid ...

JR-80741 #LI-PM1 #Indeed Talroo - Health Plan Health, Wellness, Educator, Coach, Cert Health ... For positions that are available as remote work, Sentara Health employs associates in the following ...

Showing results 21-40

Remote Prominence Health Plan information

What is the difference between Remote Prominence Health Plan vs Remote Medical Coder?

AspectRemote Prominence Health PlanRemote Medical Coder
Required CredentialsHealth insurance knowledge, possibly certifications like CPC or CCSCertification in coding (CPC, CCS), medical terminology knowledge
Work EnvironmentRemote, healthcare insurance settingRemote, healthcare documentation and billing
Employer & IndustryHealth insurance providers, managed care organizationsHospitals, clinics, billing companies
Common Search/ComparisonInsurance plan roles, healthcare benefitsMedical coding jobs, billing specialists

Remote Prominence Health Plan typically involves managing insurance plans, benefits, and member services, requiring knowledge of healthcare policies. Remote Medical Coders focus on translating medical records into codes for billing, requiring coding certifications. Both roles are remote healthcare positions but differ in daily tasks and required credentials.

What is a remote Prominence Health Plan?

A Remote Prominence Health Plan job typically refers to a position with Prominence Health Plan that allows employees to work from home or another remote location, rather than in a traditional office setting. These roles can vary widely and may include positions in customer service, claims processing, care coordination, or other administrative functions within the health insurance sector. Working remotely for Prominence Health Plan typically requires reliable internet access, a suitable workspace, and proficiency with digital communication tools. Employees benefit from flexible work arrangements while supporting the delivery of healthcare services and insurance solutions to members.

What are some common challenges faced by professionals working remotely for Prominence Health Plan, and how can they be successfully managed?

Working remotely for Prominence Health Plan often involves collaborating with cross-functional teams across different time zones, which can make communication and scheduling a challenge. Staying organized and proactive in communication—such as utilizing project management tools and regularly participating in virtual meetings—can help address these hurdles. Additionally, remote employees may need to adapt to evolving healthcare regulations and maintain strict data security practices. Building a strong rapport with team members and seeking ongoing feedback can also enhance productivity and job satisfaction in a remote setting.

What are the key skills and qualifications needed to thrive as a remote Prominence Health Plan specialist, and why are they important?

To thrive as a Remote Health Plan Specialist, you need a solid understanding of healthcare insurance policies, benefits administration, and regulatory compliance, typically requiring experience in health insurance or related certifications. Familiarity with CRM software, claims processing systems, and telehealth platforms is important for managing member inquiries and documentation remotely. Excellent communication, attention to detail, and problem-solving skills are crucial for effectively assisting members and resolving complex issues. These competencies ensure accurate service delivery, member satisfaction, and compliance with industry standards in a remote work environment.
What are the most commonly searched types of Prominence Health Plan jobs in Florida? The most popular types of Prominence Health Plan jobs in Florida are:
What cities in Florida are hiring for Remote Prominence Health Plan jobs? Cities in Florida with the most Remote Prominence Health Plan job openings:

Senior Health Educator- Asthma Educator - Remote

Molina Healthcare

Miami, FL • Remote

$49K - $90K/yr

Full-time

Re-posted 17 days ago


Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 199 frontline employees who took The Breakroom Quiz

163rd of 304 rated insurance


Job description

JOB DESCRIPTION Job Summary

Provides senior level support for health education activities.  Responsible for developing, implementing, and maintaining health plan health education programs.  Assists in identifying health education program needs, researching and developing health education and disease management materials, and maintenance of member quality programs.  Conducts data collection, reporting, and monitoring in accordance with established state/federal/National Committee for Quality Assurance (NCQA) standards and regulations.

This position is focused on Asthma care and is seeking experience in asthma instruction with a preferred AE-C.  Please make sure to include any experience in this qualifier on your resume.  This is for a pediatric population. 

Essential Job Duties

• Develops, implements and evaluates health education programs for members within the Molina network and the broader community.  
• Provides oversight and assistance to providers in meeting health education contract requirements.  
• Serves as a resource for health educators in the resolution of issues that may arise during the implementation of quality improvement (QI) interventions. 
• Identifies, designs, implements, and evaluates health education interventions to meet the needs of the targeted population based on priorities established by the department and current contracts. 
• Conducts population, geographic, and member-specific needs assessments.
• Coordinates the health education services assessment of Independent Physician Association (IPAs) and medical groups as required and collaborates with other quality improvement (QI) staff on oversight.
• Represents as a liaison to internal departments, community-based organizations (CBOs), social service agencies and public health departments to ensure that Molina resource information is current and available.
• Participates in the development of internal resources in collaboration with other departments identified in the annual work plan. 
• Reviews and updates health education materials and programs, including preventive care guidelines, incentive packets, the health plan website and communications to providers. 
• Successfully engages members in health promotion via direct member calls.
• Coordinates care of members from call tracking boxes and health education voicemails, including connecting members to appropriate programs and resources.
• May collaborate with various grant recipients, state and local entities that work toward improving the health of Molina members.
• Participates in QI planning and project work to further QI goals (e.g., Healthcare Effectiveness Data and Information Set (HEDIS) activities, strategic planning, and special projects).
• Provides input on the design and functionality of all utilized databases.
• May serve as the designated QI representative at various external activities to include immunization, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT), chronic condition collaborative and other work group meetings.
• Participates in QI planning and project work to further QI goals (e.g., HEDIS activities, and special projects).
• Provides training and support to new and existing health education team members.
• This position may require same day out of office travel 0 - 80% of the time, depending upon state-specific needs.
• This position may require multi-day overnight travel on occasion, depending upon state-specific needs.
 

Required Qualifications

• At least 3 years of experience in a health education-related capacity, and at least 1 of year experience working with a wide range of member populations within a managed care setting, or equivalent combination of relevant education and experience. 
• Ability to build relationships with community-based organizations (CBOs).
• Strong customer service skills.
• Knowledge of available community resources.
• Knowledge and understanding of HEDIS and NCQA.
• Critical-thinking, problem-solving and analytical skills.
• Ability to navigate change with flexibility and a positive outlook.
• Effective verbal, written and interpersonal communication skills.
• Microsoft Office suite and applicable software programs proficiency, and ability to learn new information systems and software programs.
 

Preferred Qualifications

• Experience with Medicaid, Medicare, and/or Marketplace government-sponsored programs.  
• Experience working with the Medicaid population.
• Certified Health Education Specialist (CHES).
 

#PJQA

#LI-AC1

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $49,930 - $90,363 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.


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About Molina Healthcare

Sourced by ZipRecruiter

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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