- CenterWell (Tallahassee, FL)
- …clinical staff to ensure clinical documentation supports medical necessity. * Support resolution of clinical questions related to authorization determinations. * ... Collaborate with Quality, Compliance, and Audit teams to support medical reviews and audits. * Translate payer requirements into operational workflows and staff… more
- CenterWell (Tallahassee, FL)
- …capability to guide senior stakeholders through complex operational challenges. You will support the reporting ecosystem for both Call Center and Back Office queues ... ensuring that data drives operational decision we make to support our patients. Strategic Leadership & Stakeholder Management + Team Leadership: Manage, mentor, and… more
- CenterWell (Tallahassee, FL)
- …Grievances & Appeals assists members, via phone or face to face, further/ support quality related goals. Investigates and resolves member and practitioner issues. ... functions strategy. **Responsibilities:** + Oversee the process for direction and support to clinical and operational leadership regarding Medicare and governmental… more
- Synchrony (Altamonte Springs, FL)
- …Lead is responsible for providing technical expertise and process execution to support the PayPal Savings program. This individual acts as the technical point ... oversight, program delivery, solution architecture, governance, audits, issue management, and support the identification of key technology risks. This role will be… more
- MyFlorida (Lakeland, FL)
- …The incumbent is part of a global public health organization and is expected to support the Florida Department of Health in Polk County in its mission to protect, ... leave time + Works closely with all clinical leadership and assists with clinical support for staff shortage to cover clinics as needed by staffing matrix +… more
- Humana (Tallahassee, FL)
- …will be an integral part of the Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The ... associate will support existing Medicaid business and expansion into new states....age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our… more
- Humana (Tallahassee, FL)
- …travel into the Humana's Louisville headquarters at least 1 time per month. + Support the creation and refinement of the Finance target state and strategic roadmap ... Office methodology to assess the impact of key initiatives. + Support the development of training, communications, and capability-building programs to position… more
- CenterWell (Orlando, FL)
- …for providers and care teams. You'll help providers document care accurately, support compliance, and drive quality outcomes in a value-based care environment. **Key ... and EMR optimization into training, aiming to reduce provider burden and support efficient, high-quality care. + Gather and apply feedback from learners and… more
- CenterWell (Tallahassee, FL)
- …relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the contracted working ... relationships with physicians, clinicians and healthcare systems in order to support and improve financial and quality performance within the contracted working… more
- Humana (Tallahassee, FL)
- …across the organization. We are hiring an Application Architect to support solution design and delivery specifically for Humana's corporate Legal technology ... all solutions follow enterprise standards for security, scalability, and resiliency. * Support projects across the SDLC and collaborate with DevOps, Security, Cloud,… more
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