- CVS Health (Tallahassee, FL)
- …requirements. + Comprehensive knowledge of coding guidelines and regulations to meet compliance requirements, such as establishing medical necessity. + Identify ... Responsible for conducting complex audits, reviews and assessments of medical records coded by internal teams prior to the...teams prior to the submission to the Centers of Medicare and Medicaid Services (CMS) for the purpose of… more
- CenterWell (Daytona Beach, FL)
- …community and help us put health first** Job Description Summary The Associate Medical Director (AMD) is an instrumental clinical leader of our primary care team, ... (clinical, financial, operational) meetings on key topics such as Medical Risk Adjustment (MRA), budgeting, staffing, operational excellence, and clinical… more
- Prime Therapeutics (Tallahassee, FL)
- …specialized needs of the targeted population; for Medicare , is Centers for Medicare & Medicaid Services (CMS) compliance compliant + Utilize Prime's MTM ... all lines of business to support the Centers for Medicare & Medicaid Services (CMS) Star and HEDIS quality...in healthcare industry + Experience working with highly confidential medical information + CPhT certification + Fluency in another… more
- CenterWell (Daytona Beach, FL)
- …medicine, continuity of care, health maintenance, and disease prevention. Keeps a medical history and medical records. Refers the patient to specialists ... accordance with standards of care. . Follows level of medical care and quality for patients and monitors care..."on-call" program of Conviva as needed. . Assures personal compliance with licensing, certification, and accrediting bodies. . Spend… more
- Fresenius Medical Center (Port St. Lucie, FL)
- …**Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans** ... nurse in accordance with organization policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal… more
- CenterWell (Belle Glade, FL)
- …doctors, advanced practice professionals, pharm D, care coach nurses, medical assistants, behavioral health, specialists, quality-based coders, referral coordinators ... accordance with standards of care. . Follows level of medical care and quality for patients and monitors care..."on-call" program of CenterWell as needed. . Assures personal compliance with licensing, certification, and accrediting bodies. . Spend… more
- CenterWell (Apopka, FL)
- …doctors, advanced practice professionals, pharm D, care coach nurses, medical assistants, behavioral health, specialists, quality-based coders, referral coordinators ... accordance with standards of care. . Follows level of medical care and quality for patients and monitors care..."on-call" program of CenterWell as needed. . Assures personal compliance with licensing, certification, and accrediting bodies. . Spend… more
- CenterWell (Delray Beach, FL)
- …Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators ... accordance with standards of care. + Follows level of medical care and quality for patients and monitors care..."on-call" program of Conviva as needed. + Assures personal compliance with licensing, certification, and accrediting bodies. + Spend… more
- Humana (Tallahassee, FL)
- …the core of this evolution is Humana's Insurance Segment, which provides Medicare Advantage, Medicaid, and other health plans to millions. By integrating insurance ... a pivotal role in defining the future of Humana's Medicare and Medicaid businesses, which generate the majority of...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
- Humana (Tallahassee, FL)
- …in determining objectives and approaches to assignments. The role is within the Medicare Finance organization. This role will be required to collaborate with various ... requests and perform valuations that help inform financial strategy related to the Medicare Advantage line of business. **Use your skills to make an impact**… more