- Evolent (Tallahassee, FL)
- …Proficiency . Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified as ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes...rationale for standard and expedited appeals. . Utilizes medical/clinical review guidelines and parameters to assure consistency in the… more
- Evolent (Tallahassee, FL)
- …Proficiency + Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified as ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes...rationale for standard and expedited appeals. + Utilizes medical/clinical review guidelines and parameters to assure consistency in the… more
- BrightSpring Health Services (Jacksonville, FL)
- …driver's license, auto insurance, and reliable transportation + Strong knowledge of health insurance plans including Medicare , Medicaid, and commercial carriers ... with insurance companies, patients, providers, and other staff + Review claims to ensure reimbursement requirements are met +...care to the warmest and most serene environment possible: home . We provide the full spectrum of hospice services,… more
- Molina Healthcare (Miami, FL)
- … Medicare . **PREFERRED EDUCATION:** Master's in Business Administration, Public Health , Healthcare Administration, etc. **PREFERRED EXPERIENCE:** + Peer Review ... medical director, and quality improvement staff. + Facilitates conformance to Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews quality referred… more
- Teleflex (Orlando, FL)
- …provider of medical technologies, Teleflex is driven by our purpose to improve the health and quality of people's lives. Through our vision to become the most ... shape the future direction of healthcare. Teleflex is the home of Arrow (TM) , Barrigel (TM) , Deknatel...by interfacing directly with medical directors/key decision makers of Medicare , BCBS, MCO's, other commercial payers * Assist in… more
- Fresenius Medical Center (Crestview, FL)
- …all regulatory and FMS policy requirements. Functions as part of the hemodialysis health care team in providing safe and effective dialysis therapy for patients ... manner. **PRINCIPAL RESPONSIBILITIES AND DUTIES** PATIENT CARE: + Assist other health care members in providing patient specific detailed education regarding… more
- CenterWell (Jacksonville, FL)
- …largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is ... part of our caring community and help us put health first** The Associate Medical Director (AMD) is an...of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify opportunities in care, ensuring… more
- Aveanna Healthcare (West Palm Beach, FL)
- …Culture, and Best CEO by Comparably in 2024 Comprehensive Benefits Package + Health , Dental, Vision, and Company-paid Life Insurance + Paid Holidays, Vacation Days, ... Conduct "Start of Care Assessments" and "Re-evaluations" to transition patients to home care. + Collaborate with operations and business development teams. +… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** **Requires a strong foundation in COBOL mainframe development ** The Claims Adjudication ... that enhance functionality, efficiency, and user satisfaction. + Design and review software solutions that meet business requirements, ensuring a smooth transition… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Senior Telesales Agent conducts selling activities related to inbound calls inquiring ... about individual health plan products. The Senior Telesales Agent work assignments...protection. Please be aware that applicants selected for leader review may be asked to provide their social security… more