- Humana (Tallahassee, FL)
- …on quality management, utilization management, case management, discharge planning and/or home health or post-acute services such as inpatient rehabilitation ... teaching conferences, and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , ...quality of care, audit, grievance and appeal and policy review . The Behavioral Health Medical Director will… more
- Humana (Palm Bay, FL)
- **Become a part of our caring community and help us put health first** Are you passionate about the Medicare population, looking for an opportunity to work in ... our consumers. **_Face to face interactions in prospective members' home are a requirement for this position._** **Use your...recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims. The ... of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Represents Humana at Administrative… more
- Humana (Tallahassee, FL)
- … first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate Medical Director works ... clinical experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate about contributing… more
- CVS Health (Tallahassee, FL)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...care resources. This is a remote based (work from home ) role. Preferred candidates will have Internal Medicine or… more
- BAYADA Home Health Care (Jacksonville, FL)
- …an experienced and compassionate **Director** to manage operations at our **Jacksonville, FL Medicare -certified Home Health office** . The ideal candidate ... with Medicare regulations and state/federal laws governing home health services. + Manage all aspects...to support business development partners and census growth. + Review and manage key financial indicators including PDGM performance,… more
- BAYADA Home Health Care (Orlando, FL)
- …Manager. The OASIS and Coding Review Manager provides support to all BAYADA Home Health Care Medicare service offices by monitoring Outcome and ... and OASIS review . + Knowledge of OASIS, Home Care and Medicare regulations + Excellent...from 8:30am-5:00pm. _Medicare, Coder, OASIS Review , Utilization Review , Quality Assurance, Remote, Home Health… more
- BAYADA Home Health Care (Orlando, FL)
- …consideration. OASIS Review , Utilization Review , Quality Assurance, Remote, Home Health Coding, Coder, Medicare **As an accredited, regulated, ... considered, there is no flexibility around this requirement.** BAYADA Home Health Care has an immediate opening...Medicare PDGM billing model and CMS guidelines. + Review and communicate OASIS edit recommendations to each clinician… more
- BayCare Health System (Sarasota, FL)
- …for Medicare & Medicaid Services (CMS), is seeking for its newest full time Home Health Registered Nurse in beautiful Venice, FL. The Home Health ... team award bonus + Community discounts and more The Home Health RN provides hands-on care in...provided are authorized and covered by physician orders + Review of patient visits weekly and providing plan to… more
- HCA Healthcare (Davie, FL)
- …qualifications you will need:** + Two years of experience within a licensed and certified ( Medicare ) home health agency required + Competent in Federal ( ... providing patients with quality care during their recovery at home . We are Medicare certified. Our patients...we encourage you to apply for our Clinical Manager Home Health opening. We review … more