• Ops Research Assistant

    MyFlorida (Tallahassee, FL)
    …Overview: The Agency for Health Care Administration (AHCA) is Florida's chief health policy and planning entity. The Agency is responsible for administering ... system to be the most cost-effective, transparent, and high-quality health care system in the nation. The Medicaid...CONTACT: YASHICA SQUIRE ### BACKGROUND SCREENING It is the policy of the Florida Agency for Health more
    MyFlorida (08/28/25)
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  • Compliance Director - FIDE (Fully Integrated Dual…

    Elevance Health (Tampa, FL)
    …will live in VA, OH, IN or FL._ _Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting ... for ensuring regulatory compliance, operational readiness, and strategic alignment across Medicare- Medicaid integrated products. **How you will make an impact:** +… more
    Elevance Health (09/05/25)
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  • Value-Based Reimbursement Specialist

    Highmark Health (Tallahassee, FL)
    …CHIP, Medicaid DE) and Enterprise Quality, Safety, and Values ( Health Outcomes Measures). Provide actionable opportunities in provider transformation aimed at ... Medicaid HEDIS, risk revenue value streams, and population health management. **Preferred** + 7 years of experience in...all areas of the corporation, by understanding corporate strategies, policy , and scope of authority + Because of the… more
    Highmark Health (08/20/25)
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  • Eligibility Specialist

    Communities Connected for Kids (Port Saint Lucie, FL)
    …as $39,000 annually + Excellent benefits including low-cost, high-coverage health insurance, generous time-off, and competitive retirement Our Communities Connected ... while remaining flexible to frequent changes in the program policy and/or computer-based systems. This position requires the following...that enters Out of Home Care. Enrolls each new Medicaid enrollee in the Sunshine Child Welfare Specialty Plan.… more
    Communities Connected for Kids (08/22/25)
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  • Community Health Worker

    CenterWell (Leesburg, FL)
    **Become a part of our caring community and help us put health first** Working within an interdisciplinary care integration team (CIT), the Community Health ... and other specialists, and implementing targeted interventions to address barriers to health and increase access to care. This role requires outreach strategies to… more
    CenterWell (08/14/25)
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  • Utilization Management Behavioral Health RN

    Humana (Tallahassee, FL)
    …Nursing experience + Previous experience in utilization management with ASAM knowledge + Health Plan experience + Previous Medicare/ Medicaid Experience a plus + ... part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
    Humana (09/04/25)
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  • Health Facility Evaluator II

    MyFlorida (Miami, FL)
    …The Agency for Health Care Administration is Florida's chief health policy and planning entity. The Agency is responsible for ... administering the Florida Medicaid program, the licensure...: NOEMI RAYNERI ### BACKGROUND SCREENING It is the policy of the Florida Agency for Health more
    MyFlorida (09/06/25)
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  • Health Facility Evaluator II

    MyFlorida (Clearwater, FL)
    …The Agency for Health Care Administration is Florida's chief health policy and planning entity. The Agency is responsible for ... administering the Florida Medicaid program, the licensure...: JOY WALERSKI ### BACKGROUND SCREENING It is the policy of the Florida Agency for Health more
    MyFlorida (08/29/25)
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  • Women's Health Clinical Account Specialist…

    Organon & Co. (Orlando, FL)
    **Job Description** **The Position** The Women's Health Clinical Account Specialist (WHCAS) supports customers by providing clinical information on our Company's ... results that are consistent with the Company's mission and goals. The Women's Health Clinical Account Specialist is the primary point of contact for a variety… more
    Organon & Co. (08/29/25)
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  • Senior Encounter Data Management Professional

    Humana (Tallahassee, FL)
    **Become a part of our caring community and help us put health first** The Senior Encounter Data Management Professional develops business processes to ensure ... successful submission and reconciliation of encounter submissions to Medicaid /Medicare. Ensures encounter submissions meet or exceed all compliance standards via… more
    Humana (08/15/25)
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