Description* This position is located in Lakeland, FL and is an on-site position; remote work opportunities are not available for this role.*About the Opportunity As Manager, Medical Administration, you will lead Publix's Workers' Compensation Medical Case Management and Medical Bill Processing functions, overseeing approximately $30 million in annual medical spend. This highly visible leadership role offers the opportunity to influence medical outcomes, cost management strategies, regulatory compliance, and associate experience across multiple states. You'll serve as a key subject matter expert, partnering with leaders throughout the organization to drive innovative healthcare solutions, improve operational effectiveness, and support healthier outcomes for Publix associates.
What You'll Do- Lead the medical case management strategy for workers' compensation claims, driving quality care and successful return-to-work outcomes.
- Manage the in-house case management and vocational rehabilitation functions.
- Direct medical bill review and payment operations across all states where Publix operates.
- Develop and execute initiatives that improve medical outcomes while controlling healthcare costs.
- Serve as the department's lead resource on workers' compensation medical regulations, legislative developments, and medico-legal matters.
- Oversee healthcare vendor relationships, performance management, and service optimization efforts.
- Monitor medical utilization, provider performance, and claim trends using data-driven insights.
- Lead the Needle Stick Safety Program, ensuring effective clinical follow-up and a positive associate experience.
- Build, develop, and mentor teams while fostering operational excellence and continuous improvement.
Additional InformationYour application may have additional steps that you will need to complete in order to remain eligible for consideration. Please be sure to monitor your email, including your spam folder, on a daily basis for critical, time-sensitive emails that could require action within 24-48 hours.
Please do not use your Publix email address when applying. Once your application has been successfully submitted you will receive a confirmation email.
For this position, Publix does not and will not file a petition or application with the USCIS or Department of State on behalf of any noncitizen for any immigration-related benefit to work and/or to continue to work in the United States, e.g., an H-1B or TN petition or permanent residence.
Year End BonusAs a year-end bonus to associates, Publix issues one month's extra pay (pro-rated in the first year) each year if associate remains employed through issue date of the bonus check that year. This is calculated as a 13th month of pay in the Potential Annual Pay with Bonus line above.
Required Qualifications- Bachelor's degree in Nursing, Healthcare Administration, Business Administration, or a related healthcare, business, or analytical field, or an equivalent combination of education and experience.
- Five years of experience in workers' compensation medical management, nurse case management, or a related healthcare function.
- Current RN licensure or other relevant healthcare administration or workers' compensation credential, as applicable.
- Experience leading people, programs, or operational teams.
- Experience supporting medical care delivery, utilization management, return-to-work programs, or medical case management.
- Knowledge of workers' compensation regulations, medical billing practices, fee schedules, and industry standards.
- Knowledge of CPT and ICD-10 coding and medical bill review processes.
- Experience using data and analytics to evaluate performance, utilization, and outcomes.
- Intermediate proficiency with Microsoft Word, Excel, and PowerPoint.
Preferred Qualifications- Master's degree in Nursing, Healthcare Administration, Business Administration, or a related field.
- Certified Case Manager (CCM), Occupational Health Certification, or multi-state RN licensure.
- Experience managing multi-state workers' compensation programs, including regulatory compliance and fee schedules.
- Experience overseeing clinical operations, medical bill review, and large-scale medical spend.
- Experience leading multidisciplinary teams, including supervisors and indirect reports.
- Experience managing external healthcare vendors, contract negotiations, and performance optimization.
- Experience using analytics to evaluate provider performance, utilization trends, and medical outcomes.
- Advanced Microsoft Excel skills and experience with business intelligence or analytics tools.
Benefits Information- Employee stock ownership plan that contributes Publix stock to associates each year at no cost
- An opportunity to purchase additional shares of our privately-held stock
- 401(k) retirement savings plan
- Group health, dental and vision plans plan
- Paid Time Off
- Paid Parental Leave
- Short- and long-term disability insurance
- Tuition reimbursement
- Free hot lunches (buffet-style) at facilities with a cafeteria
- Visit our website to see all of our benefits: Benefits - Jobs (publix.com)
