- Highmark Health (Tallahassee, FL)
- …all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the ... Serves as first line reviewer in monitoring and ensuring adherence to the health plan's state and federal multiple drug benefit design offerings. The incumbent… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to ... services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work assignments are varied and frequently require… more
- HCA Healthcare (Niceville, FL)
- …healthcare provider. We are seeking a(an) RN Infection Prevention and Employee Health to join our healthcare family. **Benefits** HCA Florida Twin Cities Hospital, ... offers a total rewards package that supports the health , life, career and retirement of our colleagues. The available plans and programs include: + Comprehensive… more
- Sedgwick (Orlando, FL)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Disability Clinical Specialist **PRIMARY PURPOSE** : To perform clinical evaluations, ... work. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Performs clinical review of referred claims ; documents decision rationale; and completes medical review of all … more
- Sedgwick (Tallahassee, FL)
- …limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance , employee assistance, flexible spending or health savings account, and ... Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Marine Investigator **PRIMARY PURPOSE** **:** To perform detailed admiralty … more
- Option Care Health (Tallahassee, FL)
- …-Flexible Spending Accounts -Tuition Reimbursement -myFlexPay -Family Support -Mental Health Services -Company Paid Life Insurance -Award/Recognition Programs ... limit to the growth of your career.** Option Care Health , Inc. is the largest independent home and alternate...+ Supports the ongoing activities needed to ensure clean claims on hold and denial management (follow-up on paperwork… more
- Elevance Health (Miami, FL)
- …responding to customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility and claims . Proficient in ... preferred. + Experience taking inbound calls, texts and chats. + Behavioral health and/or managed care experience preferred. + Proficiency in typing with speed… more
- Elevance Health (FL)
- …and models data including risk reporting and forecasting. + Calculates monthly claims liability reserves, develops merit rating factors and prepares Department of ... Insurance annual statement exhibits. **Minimum Requirements:** Requires a BA/BS...Jersey, New York In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package,… more
- Elevance Health (Miami, FL)
- …be licensed in multiple states in a timely basis. + Knowledge of health insurance /benefits strongly preferred. + Transplant experience strongly preferred. Please ... monitor, and evaluate care plans designed to optimize member health care across the care continuum and ensuring member...treatment plans. + Assists in problem solving with providers, claims or service issues. + Assists with development of… more
- Aveanna Healthcare (Fort Lauderdale, FL)
- …Perform other duties as assigned Benefits Offerings: + 401(k) with company match + Health , dental, vision, life, and pet insurance + Mileage reimbursement and ... Home Health RN Operations Manager 10K Sign On Bonus...compliance with all Federal and State regulations governing Home Health Care Agencies, and ensuring compliance with Aveanna's policies… more