- Molina Healthcare (Jacksonville, FL)
- …Validation) team, contributing to the end-to-end data strategy and execution of CMS and internal audit activities. This position is responsible for supporting RADV ... + Support RADV audit execution by identifying appropriate data sources, validating CMS audit samples, and generating chart retrieval chase lists in coordination with… more
- Publix (Lakeland, FL)
- …development team responsible for developing features on Publix.com using Sitecore CMS . Your primary responsibility will be designing and developing solutions using ... Sitecore CMS , ASP.NET, C#, JavaScript, HTML, and CSS. **Job Responsibilities:**...Responsibilities:** + Develop and maintain web solutions using Sitecore CMS + Participate in agile scrum events + Participate… more
- Highmark Health (Tallahassee, FL)
- …Analyst is responsible for monitoring and analyzing medical and utilization management activities to ensure compliance with internal policies, state, CMS ... departments. The Analyst conducts audits of Medical Directors, Utilization Management (UM) and Case Management (CM) processes...not limited to NIST, HITRUST, PCI, HIPAA, SOC, MAR, CMS , JCAHO, in order to identify, assess, prioritize, evaluate… more
- CVS Health (Tallahassee, FL)
- …codes that are submitted to the Centers for Medicare and Medicaid Services ( CMS ) for the purpose of risk adjustment processes are appropriate, accurate, and ... process audits to ensure compliance with internal policies and procedures and existing CMS regulations. + Ability to work independently as well as in a cross… more
- Humana (Tampa, FL)
- …Bachelor's degree + 10 plus years' experience in health insurance operations, complaint management , and CMS STARs programs (experience in large national insurers ... serve as a strategic leader overseeing initiatives to improve CMS STAR ratings and manage Complaint Tracking Metrics (CTMs)...annual revenue. + Collaborate with peer leaders in Risk Management and Grievances & Appeals to implement best practices… more
- University of Miami (Doral, FL)
- …funds. + Maintains appropriate records, files, and accurate documentation in the system of record. + Adheres to University and unit-level policies and procedures ... not limited to: OSHA, HIPAA, JC, AHCA, EMTALA, and CMS . AREA SPECIFIC ER + Must possess a good...generally accepted accounting principles with excellent mathematical and cash management skills. + Ability to establish and maintain effective… more
- Elevance Health (Tampa, FL)
- …position is part of our NGS (National Government Services) division which, per CMS TDL 190275, requires foreign national applicants meet the residency requirement of ... : + Degree in Accounting preferred. + Knowledge of CMS program regulations and cost report format preferred. +...regulations and cost report format preferred. + Knowledge of CMS computer systems and Microsoft Office Word and Excel… more
- CVS Health (Tallahassee, FL)
- …3 years experience in utilizing Avaya CMS Supervisor, Five9 or similar ACD system for contact center management and reporting. + Minimum 3 years experience ... - Ensure the accuracy of agent skilling and attribute profiles within Verint, Avaya CMS , 5Nine and the specialty Rx processing system (SPRx). 5% - Communicate… more
- Carnival Cruise Line (Miami, FL)
- …manage reporting through termination. + Contract Management : Utilize Carnival's Contract Management System ( CMS ) to route contract documents for approval ... approvals and promptly escalate any issues. Job Functions: + Contract Lifecycle Management : Overseeing sections of the contract lifecycle, from initiation to renewal… more
- Pearl Interactive Network (Tallahassee, FL)
- …GovWin, FedBizOpps (FBO), Federal Procurement Data System (FPDS), and the System for Award Management (SAM). + Strong leadership skills with experience ... Develop and refine a 3-year growth roadmap covering target federal agencies ( CMS , VA, HHS, SSA, DOD), state agencies (including Medicaid/Exchange programs) and… more