We are seeking a Supervisor, MMA Care Management 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 Supervisor, MMA Care Management plays a vital role in supervising a care management team that supports members enrolled in the Managed Medical Assistant (MMA) Program that qualify to receive care management services. The Supervisor, MMA Care Management ensures care management activities are completed timely, efficiently, compassionately, and in compliance with regulatory standards, contractual requirements, and organizational goals. Key responsibilities include monitoring team performance, reviewing and evaluating work quality, conducting quality assurance activities, and taking corrective action as needed to promote enrollee satisfaction and high-quality service delivery. The Supervisor, MMA Care Management provides ongoing coaching, training, and support to staff while fostering a collaborative team environment that encourages accountability, professional growth, and positive member outcomes. By facilitating communication between Care Managers, leadership, providers, and interdisciplinary partners, the Supervisor, MMA Care Management helps enhance care coordination processes and the overall member experience.
Minimum Qualifications:
State of Florida licensed registered nurse (RN).Two (2) years of pediatric experience and at least two (2) years of relevant experience working with NF, PDN, PPEC, or MFC populations and services, orState of Florida licensed registered nurse (RN) with a minimum of two (2) years of experience with pregnancy or medically complex populations, orMaster’s degree in social work (MSW) with a minimum of two (2) years of pediatric experience and at least two (2) years of relevant experience working with NF, PDN, PPEC, or MFC populations and services.Familiarity with healthcare systems, community resources, and relevant regulatory requirements.Proficiency in documentation, reporting, and use of electronic health records or case management software.Proficient in Microsoft Office applications.Preferred Qualifications:
Certification in Case Management (CCM) or related professional credential.At least one year of supervisory or team leadership experience in healthcare or social services setting.Experience working with diverse member populations and complex care needs.Demonstrated success in quality improvement initiatives or program development.Responsibilities:
Demonstrate commitment to Our Mission and models ILS Experience Standards of Excellence.Lead and supervise a care management team to ensure high-quality, member-centered service delivery and achievement of departmental goals.Monitor care management activities, staff productivity, and caseload performance to ensure timely completion of assessments, care plans, documentation, and follow-up activities.Ensure compliance with organizational policies, contractual requirements, and state/federal regulations through routine oversight, audits, and corrective action as needed.Provide ongoing coaching, performance feedback, training, and professional development to strengthen staff skills, accountability, and engagement.Review dashboards, reports, and operational data to identify trends, address gaps, and implement process improvements that enhance team outcomes.Collaborate with providers, families, interdisciplinary teams, and community resources to support individualized, person-centered care plans and resolve complex member issues.Promote member satisfaction and continuity of care by ensuring responsive service delivery, effective care transitions, and timely resolution of concerns.Perform other duties as assigned. Read LessWe are seeking an Accountant I 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 an Accountant I 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. The Accountant I in the Health Care Services industry plays a critical role in maintaining accurate financial records and supporting the organization's fiscal health. This position is responsible for processing financial transactions, reconciling accounts, and assisting with the preparation of financial reports to ensure compliance with regulatory standards. The role requires meticulous attention to detail to identify discrepancies and support audit activities, contributing to transparent and reliable financial operations. The Accountant I collaborates closely with other departments to gather necessary financial data and supports budgeting and forecasting efforts. Ultimately, this position ensures that the organization's financial practices align with industry regulations and internal policies, facilitating sound financial decision-making.
Minimum Qualifications:
Associate's degree in Accounting, Finance, or a related fieldBasic understanding of accounting principles and financial reporting.Proficiency in Microsoft Excel and accounting software (e.g., QuickBooks, SAP).Ability to handle confidential information with integrity.Relevant experience may substitute for the educational requirement on a year-for-year basis.Preferred Qualifications:
Bachelor’s degree in Accounting, Finance, or a related field.Experience working in the healthcare industry or familiarity with healthcare financial regulations.Knowledge of Generally Accepted Accounting Principles (GAAP).Certification such as CPA (Certified Public Accountant) or CMA (Certified Management Accountant) is a plus.Experience with electronic health record (EHR) systems or healthcare billing software.Responsibilities:
Record and process daily financial transactions including accounts payable and receivable.Reconcile bank statements and general ledger accounts to ensure accuracy.Assist in the preparation of monthly, quarterly, and annual financial reports.Support internal and external audit processes by providing necessary documentation and explanations. Collaborate with department heads to collect financial data and assist in budget preparation.Identify and resolve discrepancies in financial records promptly. Utilize accounting software to update and maintain financial information.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 an essential 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 Provider Relations Account Executive will work collaboratively with internal teams to align provider capabilities with organizational goals, enhancing member access and satisfaction. By proactively managing provider relationships, the Provider Relations Account Executive contributes to the overall efficiency and quality of healthcare services offered. Ultimately, the Provider Relations Account Executive 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.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 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 strong collaborative relationships with providers through high-touch communication to ensure network adequacy and quality and other provider performance goals are met.Facilitate the development, negotiation, and execution of provider contracts, ensuring terms meet regulatory standards and organizational policies.Monitor provider performance metrics and work with providers to implement corrective action plans when necessary.Serve as the primary point of contact for all assigned providers, and as a link to various départements to address inquiries, resolve disputes, and maintain positive partnerships.. Maintain accurate records of provider interactions and follow up on outstanding issues to ensure timely resolution.Collaborate with cross-functional teams including care management, compliance, and finance to support provider network initiatives and improve service delivery. opportunities for growth and expansion within existing provider accounts.
Ensure high levels of provider satisfaction by providing exceptional service and support.Page Break
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 an essential 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 Provider Relations Account Executive will work collaboratively with internal teams to align provider capabilities with organizational goals, enhancing member access and satisfaction. By proactively managing provider relationships, the Provider Relations Account Executive contributes to the overall efficiency and quality of healthcare services offered. Ultimately, the Provider Relations Account Executive 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.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 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 strong collaborative relationships with providers through high-touch communication to ensure network adequacy and quality and other provider performance goals are met.Facilitate the development, negotiation, and execution of provider contracts, ensuring terms meet regulatory standards and organizational policies.Monitor provider performance metrics and work with providers to implement corrective action plans when necessary.Serve as the primary point of contact for all assigned providers, and as a link to various départements to address inquiries, resolve disputes, and maintain positive partnerships.. Maintain accurate records of provider interactions and follow up on outstanding issues to ensure timely resolution.Collaborate with cross-functional teams including care management, compliance, and finance to support provider network initiatives and improve service delivery. opportunities for growth and expansion within existing provider accounts.
Ensure high levels of provider satisfaction by providing exceptional service and support.Page Break
We are seeking a Care 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 Care Coordinator (IDD) plays an essential role in managing and coordinating comprehensive care for eligible individuals with intellectual and developmental disabilities. The Care Coordinator (IDD) ensures members receive coordinated, person-centered services that promote their health, well-being, independence, and quality of life. Core responsibilities include assessing individual needs, developing person-centered support plans, coordinating services and supports, facilitating seamless transitions between care settings, and monitoring progress to adjust care plans as needed. The Care Coordinator (IDD) collaborates closely with multidisciplinary teams, including healthcare providers, social workers, families, and community resources, to streamline access to care and necessary services. Acting as an advocate and liaison between members, their families, and the care delivery system, the Care Coordinator (IDD) helps ensure care aligns with clinical guidelines, individual preferences, and program requirements while supporting optimal outcomes throughout the member’s care journey.
Minimum Qualifications:
With the following qualifications, have a minimum of two (2) years of relevant experience working with individuals with intellectual developmental disabilities:Bachelor’s degree in social work, sociology, psychology, gerontology, or related social services field.Bachelor's degree in a field other than social science.Registered Nurse (RN) licensed to practice in the state of Florida. Licensed Practical Nurse (LPN) with a minimum of four (4) years of relevant experience working with individuals with intellectual developmental disabilities.Relevant professional human service experience may substitute for the educational requirement on a year-for-year basis.Proficiency in electronic health records (EHR) and basic computer applications.Preferred Qualifications:
Master’s degree in social work, public health, or related field.Certification in care coordination or case management (e.g., CCM, CCRC).Experience with Medicaid waiver programs or other disability support services.Familiarity with behavioral health interventions and supports.Responsibilities:
Demonstrate commitment to Our Mission and models ILS Experience Standards of Excellence.Serve as the primary point of contact for the member and their authorized representatives.Assess member needs, identify care gaps, and assist members and their families in the development of a person-centered support plan.Monitor member’s progress and adjust care plans as necessary to address changing needs and ensure continuity of care.Coordinate services and care across the continuum and facilitate communication with providers and community resources.Provide education and support on available resources and self-advocacy.Maintain accurate documentation and ensure compliance with policies, regulations, and quality standards.Perform other duties as assigned. Read LessWe are seeking a System Configuration 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 Coordinator, System Configuration plays a critical role in ensuring the accuracy, completeness, and appropriateness of claim determinations and payments. This position is responsible for testing and reviewing claims including adjustments to support accurate system configuration and efficient claims processing. The coordinator works closely with internal teams to validate system updates, analyze processing issues, and identify opportunities for improvement. Additionally, this role supports staff through training and guidance, helping to ensure consistent application of policies and procedures across the organization.
Minimum Qualifications:
High School diploma / GED requiredAt least 2 years of experience in system configuration or administration within a healthcare environment.Knowledge of UB04 / CMS1500 claims, ICD-10 / Revenue / CPT / HCPCS diagnosis and procedure coding, claim adjudication processes, EDI and OCR claim submission.Proven ability to effectively and efficiently analyze data and summarize in an organized and professional manner. Relevant experience may substitute for the educational requirement on a year-for-year basis.Preferred Qualifications:
Associate’s degree in Health Information Management, Information Technology, Computer Science, or a related field.Certified Professional in Healthcare Information and Management Systems - CPHIMS).Knowledge of database managementResponsibilities:
Support testing of claim adjudication system programming, including benefit thresholds, authorization rules, and timely filing parameters.Assist with testing and validation of system modifications before migration to production.Review and analyze claims and adjustments to ensure correct pricing and identify root causes of processing errors.Identify trends and recommend policy or procedure changes to improve accuracy and performance.Provide guidance and support to staff on coding, edits, and policy application, and maintain quality data. Read LessWe 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 an essential 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 Claims 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 services by maintaining transparent and accountable claims operations.
Minimum Qualifications:
Bachelor’s degree in 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 Health Administration, or a related field.Certification such as Certified Internal Auditor (CIA), Certified Professional Coder (CPC), or Certified Healthcare Auditor (CHA).Experience with claims management software.Familiarity with fraud detection techniques and health care fraud prevention programs.Demonstrated ability to lead audit projects or mentor junior auditors.Responsibilities:
Demonstrate commitment to Our Mission and models ILS Experience Standards of Excellence.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.Perform other duties as assigned.We are seeking a Care Manager 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 Care Manager Assistant plays a vital role in supporting care managers to ensure the delivery of high-quality, member-centered healthcare services. This position involves coordinating communication between members, healthcare providers, and support services to facilitate effective care plans and follow-ups. The care manager assistant helps manage member records, schedules appointments, and assists in monitoring member progress to promote optimal health outcomes. By providing administrative and logistical support, the Care Manager Assistant enables care managers to focus on clinical decision-making and personalized care strategies. Ultimately, this role contributes to improving patient satisfaction and the overall efficiency of healthcare service delivery. The Case Manager Assistant is responsible to assist Case Managers in the implementation of various interventions in members’ individualized care plans.
Minimum Qualifications:
High school diploma or GED. 1+ years in healthcare experience.Basic knowledge of healthcare terminology and patient care processes.Proficiency in using electronic health record (EHR) systems and standard office software.Ability to handle sensitive information with discretion and maintain patient confidentiality.Preferred Qualifications:
Associate degree in healthcare or related field preferred.Familiarity with healthcare regulations such as HIPAA and patient privacy standards.Experience working in a healthcare setting, particularly in care coordination or case management support.Certification in medical administration or healthcare support services.Bilingual abilities to support diverse patient populations.Training in customer service or patient advocacy.Responsibilities:
Assist care managers in coordinating patient care activities and follow-up appointments.Maintain and update accurate patient records and documentation in compliance with healthcare regulations.Communicate effectively with members, families, and healthcare providers to facilitate care plans and address concerns.Help monitor patient progress and report relevant information to care managers for timely interventions.Prepare and organize care management reports and documentation for internal and external use. Read LessWe are seeking a Care 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 Care Coordinator (IDD) plays an essential role in managing and coordinating comprehensive care for eligible individuals with intellectual and developmental disabilities. The Care Coordinator (IDD) ensures members receive coordinated, person-centered services that promote their health, well-being, independence, and quality of life. Core responsibilities include assessing individual needs, developing person-centered support plans, coordinating services and supports, facilitating seamless transitions between care settings, and monitoring progress to adjust care plans as needed. The Care Coordinator (IDD) collaborates closely with multidisciplinary teams, including healthcare providers, social workers, families, and community resources, to streamline access to care and necessary services. Acting as an advocate and liaison between members, their families, and the care delivery system, the Care Coordinator (IDD) helps ensure care aligns with clinical guidelines, individual preferences, and program requirements while supporting optimal outcomes throughout the member’s care journey.
Minimum Qualifications:
With the following qualifications, have a minimum of two (2) years of relevant experience working with individuals with intellectual developmental disabilities:Bachelor’s degree in social work, sociology, psychology, gerontology, or related social services field.Bachelor's degree in a field other than social science.Registered Nurse (RN) licensed to practice in the state of Florida. Licensed Practical Nurse (LPN) with a minimum of four (4) years of relevant experience working with individuals with intellectual developmental disabilities.Relevant professional human service experience may substitute for the educational requirement on a year-for-year basis.Proficiency in electronic health records (EHR) and basic computer applications.Preferred Qualifications:
Master’s degree in social work, public health, or related field.Certification in care coordination or case management (e.g., CCM, CCRC).Experience with Medicaid waiver programs or other disability support services.Familiarity with behavioral health interventions and supports.Responsibilities:
Demonstrate commitment to Our Mission and models ILS Experience Standards of Excellence.Serve as the primary point of contact for the member and their authorized representatives.Assess member needs, identify care gaps, and assist members and their families in the development of a person-centered support plan.Monitor member’s progress and adjust care plans as necessary to address changing needs and ensure continuity of care.Coordinate services and care across the continuum and facilitate communication with providers and community resources.Provide education and support on available resources and self-advocacy.Maintain accurate documentation and ensure compliance with policies, regulations, and quality standards.Perform other duties as assigned. Read LessWe are seeking a Care 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 Care Coordinator (IDD) plays an essential role in managing and coordinating comprehensive care for eligible individuals with intellectual and developmental disabilities. The Care Coordinator (IDD) ensures members receive coordinated, person-centered services that promote their health, well-being, independence, and quality of life. Core responsibilities include assessing individual needs, developing person-centered support plans, coordinating services and supports, facilitating seamless transitions between care settings, and monitoring progress to adjust care plans as needed. The Care Coordinator (IDD) collaborates closely with multidisciplinary teams, including healthcare providers, social workers, families, and community resources, to streamline access to care and necessary services. Acting as an advocate and liaison between members, their families, and the care delivery system, the Care Coordinator (IDD) helps ensure care aligns with clinical guidelines, individual preferences, and program requirements while supporting optimal outcomes throughout the member’s care journey.
Minimum Qualifications:
With the following qualifications, have a minimum of two (2) years of relevant experience working with individuals with intellectual developmental disabilities:Bachelor’s degree in social work, sociology, psychology, gerontology, or related social services field.Bachelor's degree in a field other than social science.Registered Nurse (RN) licensed to practice in the state of Florida. Licensed Practical Nurse (LPN) with a minimum of four (4) years of relevant experience working with individuals with intellectual developmental disabilities.Relevant professional human service experience may substitute for the educational requirement on a year-for-year basis.Proficiency in electronic health records (EHR) and basic computer applications.Preferred Qualifications:
Master’s degree in social work, public health, or related field.Certification in care coordination or case management (e.g., CCM, CCRC).Experience with Medicaid waiver programs or other disability support services.Familiarity with behavioral health interventions and supports.Responsibilities:
Demonstrate commitment to Our Mission and models ILS Experience Standards of Excellence.Serve as the primary point of contact for the member and their authorized representatives.Assess member needs, identify care gaps, and assist members and their families in the development of a person-centered support plan.Monitor member’s progress and adjust care plans as necessary to address changing needs and ensure continuity of care.Coordinate services and care across the continuum and facilitate communication with providers and community resources.Provide education and support on available resources and self-advocacy.Maintain accurate documentation and ensure compliance with policies, regulations, and quality standards.Perform other duties as assigned. Read Less