Health Advocates jobs in Miami, FL

Benefits We Offer: + Comprehensive health, prescription, dental, vision, life, and disability plans + Competitive pay rates + Referral opportunities ? Refer a friend & Cash in! + Travel reimbursement and per diem allowances + Employee discounts + Educational opportunities Health Advocates Network was founded based on a shared aspiration to improve the way healthcare staffing is done. We are a company founded by healthcare professionals and built for healthcare professionals. As your true advocates, we will always help you thrive and pave the path forward in your career. Our talented staffing team is committed to providing exceptional customer service, great opportunities with top pay and benefits. From Per Diem to Travel Contracts, miles away or local to you, Health Advocates Network can find you just what you are looking for. Allow us to get you to you next adventure! Health Advocates Network, Inc. is an equal opportunity employer. All qualified applicants shall receive consideration for employment without regard to any legally protected basis under applicable federal, state or local law, except where a bona fide occupational qualification applies. EOE including Veterans/Disability

Job Description About Us Join us in making a career in Independent Living Systems, an industry leader in managing home and community-based programs for over 20 years. Independent Living Systems, LLC and its subsidiaries offer a comprehensive range of clinical and third-party administrative services to managed care organizations and providers that serve high-cost, complex member populations in the Medicare, Medicaid, and Dual-Eligible Market. ILS provides tailored integrated solutions aimed at improving health outcomes while rebalancing costs, addressing social determinants of health and connecting members with community-based resources. ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations. Position Summary The Care Coordinator is responsible for coordinating a continuum of care activities for the enrollees, ensuring optimum utilization of resources to improve their quality of life as well as assisting them to live and work in the setting of their choice. Through care coordination FCC ensures the enrollee's needs are being met and prevents fragmentation of care. It involves developing a comprehensive and individualized care plan using a person-centered approach, in conjunction with the enrollee and their authorized representative based on identified problems, challenges, barriers and goals. FCC Care Coordinators are the key element in the FCC Integrated Model of Care. Education & Experience Care Coordinators with the following qualifications also have a minimum of two (2) years of relevant experience: a) Bachelor's degree in social work, sociology, psychology, gerontology, or related social services field or b) Registered nurse licensed to practice in the state or c) Bachelor's degree in a field other than social science. Care Coordinators with the following qualifications have a minimum of four (4) years of relevant experience: License Practical Nurse licensed to practice in the state. Relevant experience may substitute for the educational requirement on a year-for-year basis. Care Coordinators without the aforementioned qualifications may substitute professional human service experience on a year-for-year basis for the educational requirement. Experience working with the developmentally disabled community preferred. EEO STATEMENT In compliance with the Drug-Free Workplace Act of 1988, Independent Living Systems has a longstanding commitment to provide a safe, quality-oriented, and productive work environment. Alcohol and drug abuse pose a threat to the health and safety of ILS employees and to the security of the company's equipment and facilities. For these reasons, ILS is committed to the elimination of drug and alcohol use and abuse in the workplace. Independent Living Systems, LLC, and its subsidiaries, including FCC, provides equal employment opportunity to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, disability, ancestry, or any other characteristic protected by state, federal, or local law. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Job Description We are seeking a Provider Relations Account Executive to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations. About the Role: The Provider Relations Account Executive plays a pivotal role in fostering and maintaining strong partnerships between our healthcare organization and a diverse network of providers. The Provider Relations Account Executive position is responsible for ensuring seamless communication, addressing provider concerns, and facilitating contract negotiations to optimize service delivery and network growth. The successful candidate will work collaboratively with internal teams to align provider capabilities with organizational goals, enhancing member access and satisfaction. By proactively managing provider relationships, the Account Executive contributes to the overall efficiency and quality of healthcare services offered. Ultimately, this role drives the expansion and retention of a high-performing provider network that supports the organization's mission and strategic objectives. Minimum Qualifications: Bachelor's degree in Healthcare Administration, Business, or a related field. Minimum of 3 years of experience in provider relations, account management, or a similar role within the healthcare industry. Strong knowledge of healthcare provider networks, contract negotiation, and regulatory compliance. Proficiency in Microsoft Office Suite and experience with healthcare management software. Relevant experience may substitute for the educational requirement on a year-for-year basis. Preferred Qualifications: Master's degree in Healthcare Administration, Business, or a related discipline. Experience working with managed care organizations or health insurance providers. Familiarity with healthcare data analytics and performance measurement tools. Demonstrated success in managing complex provider networks and multi-stakeholder projects. Certification in healthcare management or provider relations (e.g., Certified Provider Relations Specialist). Responsibilities: Develop and maintain relationships with practitioners through high-touch communication Identify opportunities for growth and expansion within existing accounts Collaborate with internal teams to develop and execute strategic plans that align with business objectives Meet and exceed performance targets through effective account management and sales strategies Ensure high levels of provider satisfaction by providing exceptional service and support

Job Description We are seeking a Claims Examiner to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations. About the Role: The Claims Examiner plays a critical role in the health care and social assistance industry by thoroughly reviewing and evaluating insurance claims to ensure accuracy, compliance, and appropriateness of payments. This position involves analyzing medical documentation, policy details, and billing information to determine the validity of claims and identify any discrepancies or potential fraud. The Examiner collaborates with healthcare providers, insurance agents, and internal teams to resolve claim issues and facilitate timely reimbursement. By maintaining up-to-date knowledge of healthcare regulations and insurance policies, the Examiner helps protect the organization from financial loss and supports the delivery of fair and efficient claims processing. Ultimately, this role contributes to the integrity and sustainability of the healthcare insurance system by ensuring claims are processed accurately and ethically. Minimum Qualifications: High school diploma or GED Minimum of 2 years experience in claims examination, medical billing, or healthcare insurance processing. Strong understanding of medical terminology, insurance policies, and healthcare billing codes (e.g., ICD-10, CPT). Proficiency with claims management software and Microsoft Office suite. Preferred Qualifications: Associate's degree or Bachelor's degree in health administration, healthcare management, or a related discipline. Certification such as Certified Professional Coder (CPC) or Certified Claims Professional (CCP). Experience working within the health care and social assistance industry or with government healthcare programs. Familiarity with regulatory frameworks such as HIPAA and the Affordable Care Act. Responsibilities: Review and analyze health insurance claims for completeness, accuracy, and compliance with policy terms and regulatory requirements. Verify medical codes, treatment documentation, and billing information to ensure services are properly covered and billed. Investigate and resolve claim discrepancies by communicating with providers, members, and internal departments. Identify and escalate potential fraudulent claims or billing errors to compliance or legal teams. Maintain detailed records of claim evaluations and stay current with healthcare laws and industry standards to support audits and improve processing workflows.

Job Description We are seeking a Driver to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations. About the Role: The Driver position is crucial to the safe and efficient driving and delivery of various products (meals, equipment, dry goods, supplies, etc.) to customer locations on an assigned route schedule. Using a positive, friendly attitude, our drivers build relationships with each customer and become familiar with their operations to meet needs and expectations. Minimum Qualifications: High school Diploma or GED. Valid FL Driver's License. 1-2 years driving experience. Preferred Qualifications: Previous experience in the healthcare services industry or related transportation roles. Additional certifications related to vehicle safety or hazardous materials handling. Demonstrated ability to manage time and prioritize deliveries under tight schedules. Responsibilities: Pickup and deliver packages to/from customer locations in a timely manner; maintain accurate inventory of packages. Operates vehicle in accordance with Company Rules, OSHA, DOT requirements, and all applicable laws. Performs pre- and post-trip inspections of assigned vehicle, documents check and notifies Supervisor of any issues. Immediately reports unsafe situations, service interruptions, incidents, or property damage to Supervisor. Demonstrates and promotes a 100% commitment to providing the best possible experience for our members.

Job Description We are seeking a Member Communications Specialist to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations. About the Role: We are seeking a highly motivated and detail-oriented Member Communications Specialist to join our team to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations. As a Member Communications Specialist, you will be responsible for developing and executing communication materials to engage and inform our members. You will work closely with cross-functional teams to ensure that all communication materials are accurate, timely, and aligned with our brand standards. Your ultimate goal will be to enhance our members' experience and satisfaction by providing them with clear and consistent information. Minimum Qualifications: Bachelor's degree in Communications, Marketing, or related field 2+ years of experience in member communications or related field Ability to communicate clearly and professionally in both written and verbal formats Ability to work independently and as part of a team Relevant experience may substitute for the educational requirement on a year-for-year basis Preferred Qualifications: Master's degree in Communications, Marketing, or related field Experience in the Health Care Services industry Familiarity with content management systems and email marketing platforms Experience with graphic design and video editing software Responsibilities: Develop and implement communication plans to engage and inform members Create and edit communication materials, including newsletters, emails, and social media posts Collaborate with cross-functional teams to ensure accuracy and consistency of messaging Track and analyze communication metrics to measure effectiveness and identify areas for improvement Stay up-to-date with industry trends and best practices in member communications

Job Description We are seeking a Delegation Oversight Specialist to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations. About the Role: The Delegation Oversight Specialist plays a critical role in ensuring that delegated healthcare tasks and responsibilities are executed in compliance with regulatory standards and organizational policies. This position is responsible for monitoring, evaluating, and improving the delegation processes to enhance member care quality and operational efficiency. The specialist collaborates closely with healthcare providers, administrative staff, and external partners to ensure clear communication and accountability in delegated functions. By identifying risks and implementing corrective actions, the role supports the organization's commitment to safe and effective healthcare delivery. Ultimately, the Delegation Oversight Specialist ensures that delegated duties are performed competently, ethically, and in alignment with the organization's strategic goals. Minimum Qualifications: Bachelor's degree in Nursing, Healthcare Administration, or a related field. Minimum of 3 years of experience in healthcare operations, clinical coordination, or regulatory compliance. Strong knowledge of healthcare regulations related to delegation and scope of practice. Knowledge of the hospital and provider networks, Florida Medicaid and HMOs Relevant experience may substitute for the educational requirement on a year-for-year basis. Preferred Qualifications: Master's degree in Healthcare Administration, Nursing, or a related discipline. Certification in healthcare compliance or quality assurance (e.g., CHC, CPHQ). Experience working in a managed care or health services organization. Familiarity with electronic health record (EHR) systems and data management tools. Demonstrated ability to lead training sessions and develop educational materials on delegation practices. Responsibilities: Monitor and evaluate the delegation of tasks within health care teams to ensure compliance with regulatory standards. Develop and implement best practices for delegation, providing guidance and support to team members. Analyze performance metrics and feedback to identify areas for improvement in delegation processes. Facilitate training sessions and workshops to enhance team members' understanding of their roles and responsibilities. Collaborate with management and other stakeholders to ensure alignment of delegation practices with organizational goals.

Job Description We are seeking a Provider Services Advocate to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations. About the Role: The Provider Services Advocate plays a critical role in supporting healthcare providers by serving as a liaison between providers and the health care organization. This position ensures that providers receive timely assistance with inquiries, claims, and service issues, ultimately enhancing provider satisfaction and operational efficiency. The advocate will analyze provider concerns, coordinate with internal departments, and facilitate resolutions to complex problems. By maintaining strong relationships and clear communication channels, the role contributes to the seamless delivery of healthcare services. The ultimate goal is to foster a collaborative environment that supports providers in delivering high-quality patient care. Minimum Qualifications: High school diploma or equivalent Experience in call center environment Knowledge of automated systems (technical adeptness) required. Demonstrated proficiency in Microsoft programs (i.e., Excel, Word, PowerPoint) required. Preferred Qualifications: Associate's or Bachelor's degree in healthcare administration or related field preferred. Experience working with Medicaid, Medicare, or commercial insurance providers. Experience processing UB04 and CMS 1500 claims Familiarity with healthcare regulatory requirements and compliance standards. Certification in healthcare customer service or provider relations. Demonstrated ability to use data analytics tools to identify trends and support decision-making. Responsibilities: Serve as the primary point of contact for healthcare providers seeking assistance with claims, billing, credentialing, and service-related inquiries. Investigate and resolve provider issues by collaborating with internal teams such as claims processing, credentialing, and customer service. Maintain accurate records of provider interactions, issues, and resolutions to ensure accountability and continuous improvement. Communicate policy updates, procedural changes, and relevant information to providers to keep them informed and compliant. Identify trends in provider concerns and recommend process improvements to enhance provider experience and operational workflows.

Job Description We are seeking a Vendor Relations Manager to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations. About the Role: The Vendor Relations Manager in the Health Care and Social Assistance industry plays a critical role in establishing and maintaining strong, productive partnerships with external vendors and service providers. This position is responsible for ensuring that all vendor interactions align with organizational goals, compliance standards, and quality expectations to support seamless healthcare delivery. The manager will oversee contract negotiations, performance evaluations, and issue resolution to optimize vendor contributions and mitigate risks. By fostering collaborative relationships, the role directly impacts operational efficiency, cost management, and service quality within the healthcare environment. Ultimately, the Vendor Relations Manager ensures that vendor partnerships contribute positively to patient care outcomes and organizational success. Minimum Qualifications: Bachelor's degree in Business Administration, Healthcare Management, or a related field. 2+ years of experience in vendor management or procurement. Strong knowledge of healthcare industry regulations, compliance standards, and vendor management best practices. Proven experience in contract negotiation and vendor performance evaluation. Relevant experience may substitute for the educational requirement on a year-for-year basis Preferred Qualifications: Master's degree in Healthcare Administration, Business, or a related discipline. Experience in the healthcare industry. Certification in vendor management or procurement. Experience with vendor management software. Responsibilities: Develop and maintain strategic relationships with healthcare vendors and suppliers to ensure high-quality service delivery and compliance with contractual obligations. Negotiate contracts, pricing, and service level agreements to achieve cost-effective and value-driven partnerships. Monitor vendor performance through regular assessments, audits, and feedback mechanisms to ensure adherence to quality and regulatory standards. Collaborate with internal departments such as procurement, legal, and clinical teams to align vendor services with organizational needs and compliance requirements. Resolve vendor-related issues promptly and effectively to minimize disruptions in healthcare operations and maintain positive working relationships.

We are seeking a Executive Assistant to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations. About the Role: The Executive Assistant in the Health Care Services industry plays a pivotal role in ensuring the smooth and efficient operation of the executive office. This position is responsible for managing complex calendars, coordinating travel arrangements, and facilitating communication between executives and internal or external stakeholders. The Executive Assistant acts as a gatekeeper, prioritizing and organizing meetings and correspondence to optimize the executive's time and productivity. Additionally, this role supports the preparation of presentations and reports, often utilizing Microsoft Office tools to deliver polished and professional materials. Ultimately, the Executive Assistant contributes to the overall effectiveness of the leadership team by providing comprehensive administrative support and anticipating the needs of the executives they serve. Minimum Qualifications: Associate degree in business administration, or related field Proven experience as an Executive Assistant or in a similar administrative role. Proficiency in Microsoft Office Suite, including Word and PowerPoint. Strong organizational and time management skills with the ability to manage multiple priorities. Ability to handle confidential information with discretion and professionalism. Relevant experience may substitute for the educational requirement on a year-for-year basis. Preferred Qualifications: Bachelor's degree in business administration, or related field. Experience working in the Health Care Services industry or a related field. Familiarity with specialized scheduling and travel management software. Experience with Microsoft Excel or other data management tools. Demonstrated ability to work effectively in a fast-paced, dynamic environment. Responsibilities: Manage and maintain executives' calendars, scheduling appointments, meetings, and events with attention to detail and priority. Coordinate complex travel arrangements including flights, accommodations, and transportation to ensure seamless itineraries. Prepare, edit, and format presentations and documents using Microsoft PowerPoint and Word to support executive communications. Arrange and facilitate meetings, including preparing agendas, taking minutes, and following up on action items. Provide general administrative assistance such as handling correspondence, managing files, and supporting special projects as needed.

We are seeking a Pharmacy Benefits Coordinator to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations. About the Role: The Pharmacy Benefits Coordinator plays a critical role in managing and optimizing pharmacy benefit programs. This position is responsible for coordinating with prescribers and targeted beneficiaries to ensure appropriate payment determination, evidence-based drug selection, and resolve medication-related problems. By maintaining accurate records and facilitating communication among stakeholders, the role helps improve patient outcomes and control pharmacy-related expenses. Minimum Qualifications: State of Florida Registered Pharmacy Technician License (RPT) required. At least 2 years of experience in managed care pharmacy required. Strong understanding of pharmacy benefit management, insurance claims processing, and healthcare regulations. Preferred Qualifications: Bachelor's degree in Health Administration, Pharmacy, Business, or a related field. Experience working with electronic health records (EHR) and pharmacy claims adjudication systems. Knowledge of Medicare, Medicaid, and commercial insurance pharmacy benefit structures. Familiarity with data analysis tools and reporting software. Bilingual in English & Spanish. Responsibilities: Engage in drug utilization review (DUR) by supporting letter campaigns, and telephonic outreach to members/providers. Maintain accurate documentation and records related to pharmacy benefits administration and communications. Monitor medication therapy management (MTM) services through prescriber follow-up and collaborations with other departments. Document and record oversight/activities in appropriate databases/software to ensure compliance with CMS and Florida Medicaid requirements. Consult with pharmacists and/or physicians regarding the use of medications and advise of appropriate formulary alternatives when requested. Respond to inquiries from other departments, physicians, and members related to formulary and prescription benefits. Refer all prescribers (MD, DO, APRN etc.) and customer calls related to medical questions to the Pharmacist.

Full-time Exempt Hybrid Schedule The Director of Underwriting for the Life & Investment Division is responsible for leading the underwriting function across a broad portfolio of life insurance and investment-linked products. This role ensures the application of sound risk assessment principles, supports product innovation, and maintains underwriting standards that align with the company's risk appetite and profitability goals. The ideal candidate brings deep technical underwriting knowledge, strong leadership skills, and experience working closely with product, actuarial, distribution, and operations teams to ensure consistent, fair, and compliant underwriting decisions and processes. This position is responsible for defining, maintaining, and ensuring consistent application of the company's underwriting philosophy and guidelines across all lines of business, as well as building, managing, and developing a high-performing underwriting team. ESSENTIAL FUNCTIONS The essential functions include, but are not limited to the following: Lead the underwriting strategy, policies, and procedures for life and investment-linked insurance products across individual and/or group lines of business. Define, maintain, and enforce underwriting guidelines and standards to ensure consistent application across all underwriters and product lines. Oversee the daily operations of the underwriting team, ensuring timely and accurate case assessments in accordance with company guidelines and regulatory standards. Build, lead, and develop the underwriting team, including recruitment, performance management, coaching, and succession planning. Collaborate with product development and actuarial teams to evaluate underwriting implications of new products and riders, pricing assumptions, and target markets. Continuously assess and update underwriting guidelines, risk tolerance levels, and reinsurance arrangements to align with emerging trends and business goals. Act as a key decision-maker or escalation point for large, complex, or high-risk cases, balancing risk exposure with customer experience and business needs. Partner with distribution and sales teams to support case placement, clarify underwriting decisions, and improve advisor experience. Lead the evaluation and implementation of underwriting technology solutions, including automated and accelerated underwriting tools. Develop and maintain relationships with reinsurers, ensuring effective use of facultative support and treaty structures. Provide training, mentorship, and development opportunities to underwriters, fostering a high-performance and learning-focused culture. Monitor underwriting performance metrics and quality assurance results; identify and address areas for improvement. Ensure compliance with applicable laws, regulations, and internal policies, and support internal/external audits as needed. Other Responsibilities Stay current on industry trends, regulatory changes, and medical advances that impact underwriting philosophy or guidelines. Contribute to strategic planning, forecasting, and risk management within the Life & Investment Division. Participate in cross-functional projects, including digital transformation initiatives, product launches, and operational process improvements. Represent the underwriting function in internal committees, leadership meetings, and cross-departmental collaborations. KEY PERFORMANCE INDICATORS (KPIs) Turnaround time and accuracy of underwriting decisions. Quality assurance and audit compliance results. Case placement rates and advisor satisfaction metrics. Portfolio persistency and loss ratio performance. Adoption rate of underwriting automation and straight-through processing. Employee engagement, retention, and performance within the underwriting team. LEADERSHIP COMPETENCIES Strategic Vision and Risk Governance. Technical Mastery in Life & Investment-Linked Underwriting. Cross-Functional Collaboration and Communication. Change Management and Digital Enablement. Ethical Decision-Making and Compliance Stewardship. MINIMUM QUALIFICATIONS Bachelor's degree in Business, Insurance, Health Sciences, or a related field; professional underwriting designations (FALU, FLMI) strongly preferred. 8-10 years of progressive underwriting experience, including at least 3-5 years in a leadership or managerial role. Deep knowledge of life and investment-linked insurance products, including medical, financial, and risk-based underwriting. Experience managing underwriting teams and enforcing underwriting guidelines. Proven ability to implement technology-driven underwriting solutions and digital workflows. Strong analytical, decision-making, and problem-solving capabilities. Excellent interpersonal and communication skills, including the ability to explain complex underwriting rationales to non-technical stakeholders. Familiarity with international life insurance and reinsurance markets (e.g., Latin America, Caribbean, Europe) preferred. Experience with treaty negotiation, facultative case handling, and cross-border regulatory environments desirable. Experience implementing and monitoring adherence to underwriting manuals, rules, and governance frameworks is strongly preferred. OUR BENEFITS We believe our people are our greatest asset, and we're committed to supporting their well-being both inside and outside of work. Our comprehensive benefits package includes: Competitive medical, dental, and vision insurance Generous paid time off and company holidays Retirement savings plan with company match Professional development and career growth opportunities Employee wellness programs and mental health resources Flexible work arrangements and a supportive team culture We're proud to offer benefits designed to help you thrive personally and professionally. WORKING CONDITIONS The following job-related working conditions are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential function. WORK ENVIRONMENT The role primarily operates in an indoor, climate-controlled office setting working in close proximity to others. Noise level in the work environment is low to moderate. Light level provides adequate brightness for reading, computer work, and other tasks without causing glare or strain. PHYSICAL DEMANDS The job primarily involves sedentary work with prolonged periods sitting at a desk. While performing the duties of this job, employees may occasionally be expected to: Exert up to 10 pounds of force and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects. Operate standard office equipment such as copiers, computers, telephones, printers, etc. TRAVEL Occasional travel (up to 10%) may be required for reinsurer meetings, training, or cross-office collaboration. SAFETY HAZARD OF THE JOB Minimal Hazards including potential ergonomic risks from prolonged sitting or repetitive motions. EEO STATEMENT VUMI Group is an equal opportunity employer. We celebrate diversity and are committed to an inclusive environment for all employees. NOTE This in no way states or implies that these are the only duties to be performed by the employee(s) incumbent in this position. Employees will be required to follow any other job-related instructions and to perform any other job-related duties requested by any person authorized to give instructions or assignments. All duties and responsibilities are subject to possible modification to reasonably accommodate individuals with disabilities. The requirements listed in this job description are the minimum levels of knowledge, skills, or abilities necessary. This job positing does not create an employment contract, implied or otherwise, other than an “at will” relationship.

Job Description We are seeking a Sr Business Analyst to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations. About the Role: As a Senior Business Analyst, you will be responsible for analyzing complex business problems and providing solutions that align with the organization's goals. You will work closely with cross-functional teams to identify areas for improvement and implement strategies to optimize business processes. Your contributions will directly impact the success of our organization and the quality of care we provide to our members. Minimum Qualifications: Bachelor's degree 2+ years of experience in business analysis or related field Strong analytical and problem-solving skills Excellent communication and presentation skills Ability to work independently and as part of a team Relevant experience may substitute for the educational requirement on a year-for-year basis. Preferred Qualifications: Master's degree Experience in the Health Care Services industry Certification in Business Analysis or related field Responsibilities: Conduct in-depth analysis of business processes and identify areas for improvement Collaborate with cross-functional teams to develop and implement solutions Create detailed reports and presentations to communicate findings and recommendations to stakeholders Stay up-to-date with industry trends and best practices to ensure the organization remains competitive Lead and mentor junior analysts to ensure the team's success

We are seeking a Specialist Accounts Payables to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations. About the Role: The Specialist Accounts Payables plays a critical role in ensuring the accurate and timely processing of all vendor invoices and payments within the healthcare and social assistance sector. This position is responsible for maintaining strong vendor relationships by resolving discrepancies and inquiries efficiently, thereby supporting the organization's financial integrity and operational continuity. The role requires meticulous attention to detail to manage large volumes of transactions while adhering to internal controls and compliance standards specific to healthcare regulations. The Specialist will collaborate closely with various departments to verify purchase orders, contracts, and expense reports, ensuring all payments are justified and documented appropriately. Ultimately, this position contributes to the organization's financial health by managing accounts payable processes that support service delivery and organizational goals. Minimum Qualifications: Associate degree in Accounting, Finance, Business Administration, or a related field. At least 2 years of experience in accounts payable or a similar financial role. Proficiency with accounting software and Microsoft Office Suite, particularly Excel. Strong understanding of accounts payable processes and internal controls. Relevant experience may substitute for the educational requirement on a year-for-year basis. Preferred Qualifications: Bachelor's degree in Accounting, Finance, Business Administration, or a related field. Experience working in the healthcare or social assistance industry. Familiarity with healthcare billing and compliance regulations such as HIPAA. Knowledge of ERP systems such as SAP, Oracle, or Workday. Certification in accounting or finance (e.g., CPA, CMA, or Certified Accounts Payable Professional). Experience with process improvement methodologies such as Lean or Six Sigma. Responsibilities: Process, verify, and reconcile vendor invoices, ensuring accuracy, compliance, and alignment with purchase orders and contracts. Manage timely invoice payments to maintain strong vendor relationships and prevent service disruptions. Investigate and resolve discrepancies by collaborating with vendors, procurement, and internal departments. Maintain organized accounts payable records and prepare reports to support month-end and year-end closing processes. Contribute to process improvements by identifying inefficiencies and recommending solutions.

Job Description We are seeking a Claims Auditor to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations. About the Role: The Claims Auditor plays a critical role in ensuring the accuracy, compliance, and integrity of health care claims within the organization. This position involves conducting thorough audits of submitted claims to verify adherence to regulatory standards, contractual obligations, and internal policies. The auditor will identify discrepancies, potential fraud, and areas for process improvement, thereby safeguarding the organization's financial health and reputation. By collaborating with claims processors, healthcare providers, and compliance teams, the auditor helps to streamline claims management and reduce errors. Ultimately, this role supports the delivery of efficient and ethical health care services by maintaining transparent and accountable claims operations. Minimum Qualifications: Bachelor's degree in Accounting, Finance, Health Administration, or a related field. At least 2 years of experience in claims auditing, health care compliance, or a similar role within the health care industry. Strong knowledge of health care claims processes, insurance billing, and regulatory requirements such as HIPAA and CMS guidelines. Proficiency in audit software and Microsoft Office Suite, particularly Excel for data analysis. Relevant experience may substitute for the educational requirement on a year-for-year basis. Preferred Qualifications: Master's degree in Accounting, Finance, Health Administration, or a related field. Certification such as Certified Internal Auditor (CIA), Certified Professional Coder (CPC), or Certified Healthcare Auditor (CHA). Experience with electronic health records (EHR) systems and claims management software. Familiarity with fraud detection techniques and health care fraud prevention programs. Advanced training or coursework in health care law, compliance, or risk management. Demonstrated ability to lead audit projects or mentor junior auditors. Responsibilities: Conduct detailed audits of healthcare claims to ensure accuracy, compliance with regulations, and adherence to organizational policies. Analyze claim data and documentation to identify errors, inconsistencies, or potential fraud. Prepare comprehensive audit reports with findings, recommendations, and corrective actions for management and stakeholders. Collaborate with claims teams and healthcare providers to resolve discrepancies and drive process improvements. Stay updated on healthcare regulations and industry best practices, while supporting internal and external audits with relevant documentation and insights.

We are seeking a Manager, Provider Relations (IDD) to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations. About the Role: The Manager, Provider Relations (IDD) plays a critical role in fostering and maintaining strong partnerships with providers who deliver services to individuals with intellectual and developmental disabilities (IDD). This position is responsible for ensuring that provider networks are robust, compliant, and aligned with organizational goals to deliver high-quality care. The manager will lead efforts to resolve provider issues, facilitate communication, and support provider development initiatives to enhance service delivery. By collaborating closely with internal teams and external stakeholders, this role ensures that providers meet regulatory requirements and contractual obligations. Ultimately, the Manager, Provider Relations (IDD) drives continuous improvement in provider engagement and satisfaction, contributing to better outcomes for individuals served within the health care system. Minimum Qualifications: Bachelor's degree in Health Care Administration, Social Work, Public Health, or a related field. Minimum of 5 years of experience in provider relations, network management, or a related role within the health care or IDD services sector. Strong knowledge of intellectual and developmental disabilities service delivery systems and regulatory requirements. Relevant experience may substitute education requirement on a year-for-year basis. Preferred Qualifications: Master's degree in a relevant field such as Health Administration, Social Work, or Public Health. Experience working with Medicaid or other government-funded health care programs. Familiarity with quality improvement methodologies and data analysis tools. Proven leadership experience managing teams or projects within a health care setting. Responsibilities: Develop and maintain strong relationships with IDD service providers to ensure effective communication and collaboration. Monitor provider performance and compliance with contractual and regulatory standards, addressing any issues proactively. Lead provider network development initiatives, including recruitment, training, and retention strategies. Serve as the primary point of contact for provider inquiries, concerns, and dispute resolution. Collaborate with internal departments such as care management, to align provider services with organizational objectives. Analyze provider data and feedback to identify trends and opportunities for improvement. Coordinate provider meetings, training sessions, and informational events to support ongoing education and engagement. Ensure timely and accurate documentation of provider interactions and activities in relevant systems.

Benefits We Offer: + Comprehensive health, prescription, dental, vision, life, and disability plans + Competitive pay rates + Referral opportunities ? Refer a friend & Cash in! + Travel reimbursement and per diem allowances + Employee discounts + Educational opportunities Health Advocates Network was founded based on a shared aspiration to improve the way healthcare staffing is done. We are a company founded by healthcare professionals and built for healthcare professionals. As your true advocates, we will always help you thrive and pave the path forward in your career. Our talented staffing team is committed to providing exceptional customer service, great opportunities with top pay and benefits. From Per Diem to Travel Contracts, miles away or local to you, Health Advocates Network can find you just what you are looking for. Allow us to get you to you next adventure! Health Advocates Network, Inc. is an equal opportunity employer. All qualified applicants shall receive consideration for employment without regard to any legally protected basis under applicable federal, state or local law, except where a bona fide occupational qualification applies. EOE including Veterans/Disability

We are seeking a Vice President, Health Plan Compliance to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations. About the Role: The Vice President of Health Plan Compliance plays a critical leadership role in ensuring that the organization adheres to all applicable federal, state, and local regulations governing health plan operations. This position is responsible for developing, implementing, and maintaining comprehensive compliance programs that mitigate risk and promote ethical business practices across the health plan. The role requires close collaboration with executive leadership, legal counsel, and operational teams to monitor regulatory changes and adapt policies accordingly. The Vice President will lead compliance audits, investigations, and training initiatives to foster a culture of compliance and accountability. Ultimately, this role ensures the organization maintains its reputation, avoids penalties, and delivers high-quality, compliant health care services to its members. Minimum Qualifications: Bachelor's degree in Health Administration, Business, Law, or a related field. At least 10 years of experience in health plan compliance or regulatory affairs within the health care services industry. Demonstrated knowledge of federal and state health care regulations including HIPAA, CMS guidelines, and the Affordable Care Act. Proven experience leading compliance programs and managing teams. Strong understanding of health plan operations and risk management principles. Relevant experience may substitute for the educational requirement on a year-for-year basis. Preferred Qualifications: Master's degree in Health Administration, Public Health, Law, or a related discipline. Certification in health care compliance such as Certified in Healthcare Compliance (CHC) or equivalent. Experience working with Medicare and Medicaid health plans. Proven track record of successfully managing regulatory audits and investigations. Responsibilities: Develop, implement, and oversee the health plan's compliance program to ensure adherence to all relevant laws, regulations, and accreditation standards. Monitor regulatory developments and assess their impact on organizational policies and procedures, providing timely guidance to leadership and staff. Collaborate with cross-functional teams including legal, operations, and quality assurance to integrate compliance requirements into business processes. Stay up-to-date on changes to laws, regulations, and policies related to health plan compliance, and ensure that the organization is in compliance with these changes. Lead and manage a team of compliance professionals.

Job Description We are seeking a Utilization Management (UM) Coordinator IDD to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations. About the Role: The Utilization Management (UM) Coordinator IDD plays a critical role in ensuring that individuals with intellectual and developmental disabilities receive timely, appropriate, and cost-effective healthcare services. The UM Coordinator is responsible for processing service authorizations, monitoring utilization trends, and collaborating with healthcare providers, families, and interdisciplinary teams to ensure care aligns with clinical and regulatory standards. This role includes both inbound and outbound communications, administrative support for precertification and prior authorization workflows, and a commitment to quality improvement and compliance. Through effective coordination and communication, the UM Coordinator helps improve outcomes for the IDD population while maintaining resource stewardship and service integrity. Minimum Qualifications: High school diploma or GED required At least two years of experience in healthcare support role such as medical assistant, office assistant, or clinical administrative support Experience in utilization management, care coordination, or case management, particularly with Medicaid or Medicare populations Strong understanding of healthcare services and supports for individuals with intellectual and developmental disabilities Familiarity with managed care principles, prior authorization processes, and regulatory compliance Proficiency with electronic health records (EHR) systems, intake portals, and healthcare data systems Relevant experience may substitute for the educational requirement on a year-for-year basis Preferred Qualifications: Associate's or Bachelor's degree in nursing, social work, health administration, public health, or a related field Certification in Utilization Review or Case Management (e.g., CPUR, CCM) Direct experience working with individuals with intellectual and developmental disabilities and their families Understanding of Medicaid waiver programs and community-based IDD services Experience working in a URAC and/or NCQA-compliant environment Bilingual proficiency (e.g., Spanish/English or Creole/English) Responsibilities: Perform intake and screening of service requests from members, providers, and families via telephone, fax, and web portals, ensuring accurate triage and referral to clinical or medical staff as appropriate. Approve services not requiring medical review according to prior authorization guidelines, ensuring accurate documentation and compliance with regulatory standards. Communicate with healthcare providers and care managers, including outbound calls to obtain clinical information necessary for medical review and service authorization decisions. Maintain detailed and accurate records in internal systems to support regulatory compliance, risk management, and quality assurance efforts. Support the precertification and utilization management process, ensuring adherence to federal, state, and accreditation requirements, and participate in team quality improvement initiatives.