- Elevance Health (Tampa, FL)
- …well as conducting clinical research, data analysis, and identification of legislative mandates to support draft development and/or revision of enterprise ... reimbursement policy. + Translates medical policies into reimbursement rules. + Performs CPT/HCPCS code and fee schedule updates, analyzing each new code for coverage, policy, reimbursement development, and implications for system edits. + Coordinates research… more
- Healthfirst (FL)
- …vendors to maintain and update edits as changes in the regulatory, legislative , or industry accepted payment policy requires. + Collaborates with other departments ... to improve compliance with coding conventions and clinical practice guidelines. + Leads continuous improvement and quality initiatives to improve processes across departments. + Reviews and responds to written provider disputes, clearly and articulately… more
- Molina Healthcare (Jacksonville, FL)
- …or equivalent combination of relevant education and experience. + Policy/government legislative review knowledge. + Strong analytical and problem-solving skills. + ... Robust knowledge of Office Product Suite including Word, Excel, Outlook and Teams. + Previous success in a dynamic and autonomous work environment. + Experience with provider data, PNV file, Network adequacy + SQL Experience. Dashboard developments **Preferred… more
- Molina Healthcare (Tampa, FL)
- …or equivalent combination of relevant education and experience. + Policy/government legislative review knowledge + Strong analytical and problem-solving skills + ... Familiarity with administration systems + Robust knowledge of Office Product Suite including Word, Excel, Outlook and Teams + Previous success in a dynamic and autonomous work environment **Preferred Qualifications** + Project implementation experience +… more
- Highmark Health (Tallahassee, FL)
- …to assigned functional areas. Continuously monitors regulatory changes, legislative efforts, industry trends, and/or contract changes. **ESSENTIAL RESPONSIBILITIES** ... + Manage and coordinate compliance related processes. + Monitor governance and compliance of rules, regulations, policies, and procedures and assist with appropriate audits, as applicable. Contacts may include legislators, consumers, special interest groups,… more
- MyFlorida (Tallahassee, FL)
- …Long-Term Resiliency, RebuildFlorida Program. The position is a Constituent Management Services Analyst and acts as initial contact for the Rebuild Florida Program. ... inquiries and alleviate any concerns received from constituents, local governments and legislative staff, in a timely manner. The incumbent must be productive under… more
- Fifth Third Bank, NA (Boca Raton, FL)
- …+ Maintains knowledge of complex, advanced planning techniques and relevant legislative , regulatory and case law changes. + Attends community and/or ... process. + SUPERVISORY RESPONSIBILITIES: + Responsible for providing Wealth Planning Analyst and Planners timely, candid and constructive feedback; develop Analysts… more