- Molina Healthcare (St. Petersburg, FL)
- …policy/procedure development, provider contracting experience. + Experience with NCQA, HEDIS , Medicaid, Medicare and Pharmacy benefit management, Group/IPA practice, ... capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment, disease management, and evidence-based guidelines. + Experience in Utilization/Quality Program management +… more
- CenterWell (St. Petersburg, FL)
- …years MA experience + Value Based Care experience including knowledge of HEDIS , CPT/ICD coding, and CAHPS/HOS Patient Experience. + Phlebotomy experience **Working ... hours** : Monday to Friday 8AM-5PM **Additional Information** **Alert** Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will… more
- CenterWell (New Smyrna Beach, FL)
- …administration experience + Value Based Care experience including knowledge of HEDIS , CPT/ICD coding, and CAHPS/HOS Patient Experience. + Bilingual proficiency in ... English and Spanish - must pass proficiency exam prior to foreign language communication **Working hours** : Monday to Friday 8AM-5PM **Additional Information** **Alert** Humana values personal identity protection. Please be aware that applicants may be asked… more
- CenterWell (Wellington, FL)
- …environment. + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators. **Additional Information** + Base salary + bi-annual bonus + ... Excellent benefit package - **_health insurance effective on your first day of employment_** + CME Allowance/Time + Occurrence Malpractice Insurance + Relocation and sign-on bonus options + 401(k) with Employer Match + Life Insurance/Disability + Paid Time… more
- CenterWell (Orange City, FL)
- …in PCO center + Value Based Care experience including knowledge of HEDIS , CPT/ICD coding, and CAHPS/HOS Patient Experience + Bilingual proficiency in English ... and Spanish - must pass proficiency exam prior to foreign language communication **Working Hours: Monday - Friday 8:00 to 5:00** **Location: Must be flexible to travel to 5 clinics in the area as needed** PLEASE MAKE SURE YOU ATTACH YOUR RESUME TO YOUR… more
- Molina Healthcare (St. Petersburg, FL)
- …sources. + Knowledge of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) + Knowledge of healthcare ... financial terms (eg, PMPM, revenue) and different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/billing (UB04/1500 form) + Demonstrated understanding of key managed care concepts and provider reimbursement principles such… more
- ChenMed (Miami, FL)
- …+ Assists with training programs for clinical personnel involved in Part D HEDIS measures in the centers of ChenMed/JenCare/Dedicated. + Performs other duties as ... assigned and modified at manager's discretion. **KNOWLEDGE, SKILLS AND ABILITIES:** + Foundational knowledge and understanding of standard medication adherence practices, protocols, techniques, functions and processes + Excellent interpersonal skills,… more
- CenterWell (Callahan, FL)
- …environment . Knowledge of Medicare guidelines and coverage . Knowledge of HEDIS quality indicators . Bilingual (English and Spanish) is a plus **Additional ... Information:** . Time with your patients . Competitive base salary + annual bonus incentive . Minimal Call . Comprehensive benefits package - _health insurance is effective on your first day of employment_ . CME Allowance/Time . Occurrence Based Malpractice… more
- ChenMed (Jacksonville, FL)
- …and execution of business strategies that increase revenue and quality ratings ( HEDIS /STARS/Clinical Gaps) and support our core model. + Develops protocols and ... procedures to improve staff productivity. Collaborates with PCPs to coach and manage clinical staff performance; implements progressive improvement plans and disciplinary action when needed. + Manages medical equipment and supply inventory. Ensures… more
- CenterWell (Jacksonville, FL)
- …administration experience + Value Based Care experience including knowledge of HEDIS , CPT/ICD coding, and CAHPS/HOS Patient Experience. + Bilingual proficiency in ... English and Spanish - must pass proficiency exam prior to foreign language communication **Working Hours: Monday - Friday 8:00 to 5:00** PLEASE MAKE SURE YOU ATTACH YOUR RESUME TO YOUR APPLICATION (PDF or Word format) This role is considered patient facing and… more