- Intermountain Health (Tallahassee, FL)
- …and promotes optimal allocation of resources while balancing clinical quality and cost management . **Job Specifics** + Pay Range: $38.77 - $59.82 Non Exempt + ... by interviewing the patient/family/significant other (SO). Assesses patient/member per CMS Condition of Participation (COP) or National Clinical Quality Association… more
- BayCare Health System (Clearwater, FL)
- …sales events. + Must adhere to all regulations set forth by CMS and maintain BayCare's values and ethical standards. **Minimum Qualifications:** **Education:** + ... + BayCarePlus Medicare Advantage Plans (https://baycare.org/medicare-advantage-plans) **Facility:** BayCare Health System , Sales-BHS **Location:** 300 Park Place Blvd Ste 170,… more
- Insight Global (Orlando, FL)
- …on department workflow. 4. Oversees current formulary within the electronic health record system as well as medication management systems to include smart ... (d) healthy work environment; (e) strategic, financial, and human resource management ; (f) legal and regulatory compliance; (g) networking, partnering, and… more
- HCA Healthcare (Orange Park, FL)
- …Advice + Payer denial/DRG downgrade letters + Complex NCD/LCD guidelines, CMS /AHCA policies and regulations + Federal Register, Center for Medicare and ... RHIA, RHIT or CCS preferred " **Parallon** provides full-service revenue cycle management , or total patient account resolution, for HCA Healthcare. Our services… more
- CenterWell (Tallahassee, FL)
- …+ Document all activity within clinic EMR and other required pharmacy or clinical management systems + Support CMS Stars and HEDIS quality measures for ... play a critical role in improving patient outcomes through effective medication management , patient education, and collaboration with our healthcare team. The role… more
- Centene Corporation (Tallahassee, FL)
- …experience _** **Position Purpose:** Assesses, plans, implements, and coordinates care management activities based on member needs to provide quality, cost-effective ... plan/service plan revision or address identified member needs, refer to care management for further evaluation as appropriate + Provides psychosocial and resource… more
- Carnival Cruise Line (Miami, FL)
- …Experience thriving in a complex and global organization. + Highly proficient in content management and planning, generative AI, Adobe Creative Suite, Canva, ... efficient use of resources to achieve project objectives. + Experience supporting intranet content design, layout, and publishing using modern CMS platforms (eg,… more
- Molina Healthcare (Miami, FL)
- …accuracy, completeness, and compliance with Centers for Medicare and Medicaid Services ( CMS ) regulations and guidelines of risk adjustment data * Understand and ... CPC credential **Preferred Education** Bachelor's Degree in Business Administration, Health Care Management o To all current Molina employees: If you are interested… more
- Molina Healthcare (St. Petersburg, FL)
- **Job Summary** This position is responsible for the holistic management of the external vendor relationships for Claims and Enrollment activities (along with other ... **Job Duties** + Develops Medicare and Medicaid vendor strategies aligned with CMS and State regulations, including contract negotiation and SLA oversight +… more
- Humana (Tallahassee, FL)
- …by other healthcare professionals are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts. ... skills, with prior experience participating in teams focusing on quality management , utilization management , case management , discharge planning… more