- Humana (Jacksonville, FL)
- …and contracting teams to promote provider engagement with CarePlus and ensuring compliance and marketing guidelines associated with Medicare regulations are ... a part of our caring community and help us put health first** Our Senior Manager, Medicare Sales - CarePlus motivates and drives a team of Medicare Sales Field… more
- Humana (Tallahassee, FL)
- …a part of our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and ... preservice appeals. The Corporate Medical Director works on problems of diverse scope and...necessity of services provided by other healthcare professionals in compliance with coverage policies, procedures, and performance standards. CMD… more
- Humana (The Villages, FL)
- …exceed $113K depending on experience and location. Are you passionate about the Medicare population, looking for an opportunity to work in sales, and wanting the ... motivated and self-driven individuals to join our team. The Medicare Sales Field Agent is dedicated to the growth...Interagency Language Rating (ILR) test as provided by the Federal Government. + Alert: Humana values personal identity protection.… more
- Public Consulting Group (Tallahassee, FL)
- …learn more, visit www.publicconsultinggroup.com . Duties & Responsibilities . Prepare Medicare and/or Medicaid cost reports for ambulance providers. . Reconcile ... general ledger and accounting assistance to financial staff. . Ensure compliance with accounting principles and procedures. . Recommend accounting process… more
- CVS Health (Tallahassee, FL)
- …lifecycle management of Aetna's integrated products (HIDE/FIDE) that serve Medicare Advantage populations, including Dual-Eligible Special Needs Plans (D-SNP). This ... care objectives. Working cross-functionally with Duals Center of Excellence, clinical, compliance , analytics and network teams, the Senior Manager drives innovation… more
- CVS Health (Tallahassee, FL)
- …part of a growing business segment, selling our competitive portfolio of Medicare products. Upon acquisition the Field Sales Representative will own the member ... Continued Education (CE's) + Product Certification + Required Security and Compliance + Client/Carrier Certifications + Any required CMS Certifications **Required… more
- Humana (Tallahassee, FL)
- …clinical reference materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage ... authorized. All work occurs with a context of regulatory compliance , and work is assisted by diverse resources which...group practice management. + Utilization management experience in a medical management review organization, such as Medicare … more
- USAA (Tampa, FL)
- …and claims experience to safeguard long-term morbidity outcomes; providing expert medical consultation on Medicare Supplement policies and claims; conducting ... with significant impact. + 4 years of experience in medical coding and/or Medicare billing practices. +...waste, and abuse. + Regulatory Experience: Experience working with Medicare state and federal regulations. + Investigation… more
- Humana (Tallahassee, FL)
- …ensuring compliance with governmental requirements for clinics across both federal and state requirements. The work assignments involve moderately complex to ... and procedures. Research compliance issues and recommends changes that assure compliance with federal and/or state requirements related to Provider Clinic… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and ... clinical reference materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage… more