Location. Centerville. Area/Department. Corporate Administration. F/T or P/T status. Full-time. Schedule/Hours. As required. Job Summary. Support the CEO, playing a critical role in driving organizational effectiveness, operational efficiency and strategic initiatives [executing the CEO's vision]. Chief of Staff will act as a key advisor and right-hand to the CEO, facilitating decision-making, managing priorities, and ensuring seamless execution ...
Location. Raymond Diehl. Area/Department. Network Services. Hours per week. 40. F/T or P/T status. Full-time. Schedule/Hours. M-F, 8 am - 5 pm. Job Summary. Identifies gaps in the provider network, fosters positive relationships with network providers, and conducts site visits. Manages credentialing, recredentialing and provider complaint processes. Minimum Qualifications. Associate's degree (A.A.) or equivalent from a two-year college or technic...
Location. Raymond Diehl. Area/Department. Network Services. Hours per week. 40. F/T or P/T status. Full-time. Schedule/Hours. M-F, 8 am - 5 pm. Job Summary. Identifies gaps in the provider network, fosters positive relationships with network providers, and conducts site visits. Manages credentialing, recredentialing and provider complaint processes. Minimum Qualifications. Associate's degree (A.A.) or equivalent from a two-year college or technic...
Capital Health Plan is a non-profit health maintenance organization with a mission to provide its members with high-quality, affordable health care. We have an exciting opportunity for a. Lifestyle Medicine Certified Primary Care Physician (Board Certified Family Practice or Internal Medicine Physician). to become a part of our highly respected, physician group. About Our Company. Capital Health Plan (CHP) is a not-for-profit mixed model health m...
Location. Raymond Diehl. Area/Department. Claims PIT. Schedule/Hours. M-F, 8am - 5pm. Must work evenings and weekends as directed. Job Summary. Researches, develops, and maintains a training curriculum and departmental workflows and work processes for Claims Operations staff. Provides training and performs quality reviews during training periods. Minimum Qualifications. Bachelor's degree (BA/BS) from four-year college or university. or one to two...
Location. Centerville Road. Area/Department. Corporate Administration. F/T or P/T status. Full-time. Schedule/Hours. As required. Job Summary. Advance organizational effectiveness, operational efficiency, and strategic execution in alignment with the CEO's vision. This role partners with executive leaders and senior management to assist in establishing the organization's strategic direction and overall priorities. Minimum Qualifications. Bachelor...
Location. Tallahassee, FL. Department. Claims. FLSA. Exempt. Schedule. . As required. About the role. We are seeking a Claims Operations Director to lead and oversee Capital Health Plan's end‑to‑end claims operations, including claims processing, other party liability (OPL) recoveries, premium billing and reconciliation, contract administration, and payment integrity functions. This role directs multiple operational teams and managers, ensuring t...
Location. Tallahassee, FL. Reports to. Chief Executive Officer (CEO). FLSA Status. Exempt. Employment Type. Full-Time. Position Summary. The Senior Vice President (SVP) of Sales and Marketing will lead the strategic direction, planning, and execution of all sales and marketing initiatives for a regional Health Maintenance Organization (HMO). This executive role is responsible for driving sustainable membership growth, brand development, market pe...
Job Title. Patient Care Representative I (Primary Care). Area/Department. Reception. Hours per week. 40. F/T or P/T status. Full-time. Schedule/Hours. M-F, 8:30 am - 5:30 pm. Job Summary. Serves as initial contact with Capital Health Plan (CHP) members seeking medical care. Answers phones and enters information into the Electronic Health Record (EHR) required for scheduling and management of health issues. Maintains appointment schedules, collect...
Area/Department:Care Coordination. Hours per week:40. F/T or P/T status:Full-time. Work schedule/hours:Monday - Friday, 8 a.m. 5 p.m. Job Summary. Provides oversight. Coordination of care for members. Coordination of care across the continuum of care while adhering to professional standards of. Perform case management. Practice and meeting regulatory standards. Minimum Qualifications. Bachelor's degree (BA/BS) from four-year college or university...
Location. Governors Square. Area/Department. Pharmacy & Therapeutics. F/T or P/T status. Full-time. Schedule/Hours. As required. Job Summary. This senior leadership role is directly responsible for the strategic and operational oversight of pharmacy services. Reporting to the Chief Medical Officer, the VP will lead the design and execution of pharmacy strategies that support quality patient care, cost management, and regulatory compliance. Minimu...
Location. Centerville Road. Area/Department. Care Coordination. F/T or P/T status. Full-time. Schedule/Hours. As Required. Job Summary. Provides oversight for grievance/appeal and organizational determinations which includes accountability within the department for monitoring compliance with all federal and state regulations including CMS, and NCQA accreditation standards. Actively participates in the daily activities related to grievance/appeals...
