- Evolent (Tallahassee, FL)
- …Minimum of 5 years in Utilization Management, health care Appeals, compliance and/or grievances/complaints in a quality improvement environment- **Required** + Able ... and verbal communication skills. - **Preferred** **To comply with HIPAA security standards (45 CFR sec. 164.308 (a) (3)),...part of the application process. This is collected for compliance and security purposes and only reviewed if an… more
- Highmark Health (Tallahassee, FL)
- …Performance Indicators, and appropriate controls for both regulatory and compliance considerations. Provides consultative services and analytic support to business ... must comply with both the Health Insurance Portability Accountability Act of 1996 ( HIPAA ) as described in the Notice of Privacy Practices and Privacy Policies and… more
- Evolent (Tallahassee, FL)
- …tools, and templates for oncology performance initiatives + Ensure strict compliance with federal and state regulations and company policies, procedures, and ... with managed care and/or provider engagement **To comply with HIPAA security standards (45 CFR sec. 164.308 (a) (3)),...part of the application process. This is collected for compliance and security purposes and only reviewed if an… more
- Amergis (North Port, FL)
- …purpose of communicating information, resolving issues and providing services in compliance with established guidelines + Coordinates meetings and processes for ... for the purpose of minimizing the adverse impact of communication disorders in compliance with regulatory requirements + Instructs eligible students in the use of… more
- AdventHealth (Altamonte Springs, FL)
- …and grants in the healthcare sector to monitor changes and assist with compliance to those changes. + Develops and maintains strategic relationships with colleagues ... and medical directorships. + Adheres to federal, state and local regulations (including HIPAA ) as they pertain to assigned tasks. + Maintains or exceeds legal… more
- Evolent (Tallahassee, FL)
- …in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission ... action by a state medical board **To comply with HIPAA security standards (45 CFR sec. 164.308 (a) (3)),...part of the application process. This is collected for compliance and security purposes and only reviewed if an… more
- Humana (Tallahassee, FL)
- …sector. + Familiarity with healthcare data standards, interoperability, and compliance frameworks. **Additional Information** To ensure Home or Hybrid Home/Office ... space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position,...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Evolent (Tallahassee, FL)
- …in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission ... action by a state medical board **To comply with HIPAA security standards (45 CFR sec. 164.308 (a) (3)),...part of the application process. This is collected for compliance and security purposes and only reviewed if an… more
- CVS Health (Tallahassee, FL)
- …high-quality client experience within the department while maintaining regulatory compliance . This role directly manages 10-12 colleagues and provides leadership ... expert advice and guidance on benefit plan design and regulatory compliance impacting plan sponsors. + Collaborate with internal departments-including claims,… more
- Evolent (Tallahassee, FL)
- …in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission ... care- **Required** + Computer Proficiency- **Required** **To comply with HIPAA security standards (45 CFR sec. 164.308 (a) (3)),...part of the application process. This is collected for compliance and security purposes and only reviewed if an… more