- Humana (Tallahassee, FL)
- …materials, internal teaching conferences, and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and ... Medicare Advantage and Managed Medicaid products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other… more
- CVS Health (Tallahassee, FL)
- …talent! We have an exciting opportunity available for highly motivated individuals as Medicare Sales Specialist. The position will be a part of a specialized team ... who will focus on educating existing Medicare members on available plan offerings to help meet...selling applicable products to existing members. + Maintaining high compliance commitment and standards with a robust knowledge with… 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 (Tallahassee, FL)
- …part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice ... appeals. The Corporate Medical Director works on problems of diverse scope and...appropriateness of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Represents… more
- CVS Health (Tallahassee, FL)
- …sales divisions of Medicare Advantage organizations, as well as operations, enrollment, compliance and finance + Mastery of Medicare Sales and Marketing ... with heart, each and every day. **Job Description** + The Sr. Manager, Medicare Sales Strategy develops and executes strategic initiatives to drive sales growth… more
- Actalent (Orlando, FL)
- …clinical trial protocols to determine the appropriate billing of services in compliance with Medicare regulations and institutional policies. This role ensures ... that billing practices align with federal guidelines and supports the financial integrity of clinical...experience in clinical research billing, coverage analysis, or healthcare compliance . + Strong knowledge of Medicare regulations… more
- Humana (Deland, FL)
- …caring community and help us put health first** Are you passionate about the Medicare population, looking for an opportunity to work in sales, and wanting the ... the community through service, organizations, activities and volunteerism + Experience selling Medicare products + Bilingual with the ability to speak, read and… 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
- AdventHealth (Maitland, FL)
- …: Maitland, FL **The role you will contribute:** The Senior Compliance Analyst applies technical, analytical, and problem-solving skills to identify, quantify, ... and present contract compliance violations. He/she will perform extensive review of contract...will perform extensive review of contract language, state and federal regulations, and payor practices to facilitate resolution of… more
- Humana (Tallahassee, FL)
- …expertise to review Medicare drug appeals (Part D & B). The Medical director work assignments involve moderately complex to complex issues where the analysis of ... situations or data requires a case-by-case consideration of the Medicare rules, Humana policies and medical necessity....policy. All work occurs within a context of regulatory compliance and work is assisted by diverse resources, included… more