• Manager Enrollment and Billing

    Healthfirst (FL)
    …with internal teams (eg, sales, customer service, compliance) to ensure seamless management of members. + Monitor ,report, and deliver updates on memberships, data ... Billing activities are managed in compliance with State and CMS guidelines and to ensure member satisfaction + Lead...Working knowledge of how data processes through systems and system integrations work to understand and plan for addressing… more
    Healthfirst (07/30/25)
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  • Auditor, Risk Adjustment (Remote)

    Molina Healthcare (Miami, FL)
    …and procedures to ensure accuracy, completeness, and compliance with Centers for Medicare and Medicaid Services ( CMS ) regulations and guidelines of risk ... 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 (07/25/25)
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  • Compliance Analyst (MI Health Plan) - REMOTE…

    Molina Healthcare (FL)
    …inquiries. + Performs Plan Required Reporting. + Interpret and analyzes Medicare , Medicaid and MMP Required Reporting Technical Specifications. + Create and ... quarterly Key Performance Indicator (KPI) reports. + Support the management of the regulatory memo distribution process Ability to...notices of proposed rulemaking. + Manages user access to CMS . + Analyze data use critical thinking + Ability… more
    Molina Healthcare (07/19/25)
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  • Administrator in Charge, Nursing Support Services…

    University of Miami (Miami, FL)
    …Ensure compliance with healthcare regulations including those set by the Centers for Medicare and Medicaid Services ( CMS ), Joint Commission and other regulatory ... the facility, ensuring the delivery of high-quality patient care, efficient management of resources and compliance with healthcare regulations. This leadership role… more
    University of Miami (07/18/25)
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  • Facility Coding Inpatient Complex Coder

    Banner Health (FL)
    …and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services ( CMS ), Office of the Inspector General (OIG) and the ... certification in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC). Requires… more
    Banner Health (07/10/25)
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  • Vice President Client Engagement - Large Plan…

    Prime Therapeutics (Tallahassee, FL)
    …benefits consultants, key state leaders, industry trade associations, and Centers for Medicare and Medicaid Services ( CMS ); establish an effective communication ... teams, ensuring adequate representation for market-specific client needs; align account management activities across all lines of business and develop methodologies,… more
    Prime Therapeutics (07/02/25)
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  • Chief Pharmacy Officer

    University of Miami (Miami, FL)
    …and local pharmacy-related laws, regulations, and rules, including but not limited to CMS (Centers for Medicare and Medicaid Services), the Joint Commission, the ... experience. Knowledge, Skills and Attitudes:* Knowledge of business and management principles.* Ability to direct, manage, implement, and evaluate department… more
    University of Miami (07/02/25)
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  • Manager Cellular Therapy Lab

    HCA Healthcare (Gainesville, FL)
    …Improvements Act (CLIA) as well as compliance with standards of the Centers for Medicare & Medicaid Services ( CMS ). The Manager supervises all employees in the ... role: + Act as the Cell Processing Laboratory Quality Management Supervisor. + Develop new, or revise policies and...staff and is the liaison between staff and upper management . + Assume responsibility and accountability for efficient and… more
    HCA Healthcare (06/21/25)
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  • Audit and Compliance Supervisor - Patient…

    BayCare Health System (Clearwater, FL)
    …field + Highly Preferred - Understanding of Government Regulatory Compliance ( CMS , AHCA, Medicare Fiscal Intermediaries) Equal Opportunity Employer ... Veterans/Disabled **Position** Audit and Compliance Supervisor - Patient Financial Services **Location** Clearwater | Leadership | Full Time **Req ID** 85104 more
    BayCare Health System (06/03/25)
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  • Epic Sr. Analyst - Quality and Population Health

    University of Miami (Miami, FL)
    …you will: + Build and maintain Clinician's workflow and HEDIS quality measure for Medicare Advantage programs + Build and maintain CMS Quality Payment Program ... tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The University of Miami Health System , "UHealth", IT Department has an exciting opportunity for… more
    University of Miami (05/31/25)
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