- Aveanna Healthcare (West Palm Beach, FL)
- …activities. Essential Job Functions * Assist Administrative Director and Clinical Manager and organize front office operations. * Maintenance of nurse licensure ... and credential expirations to ensure compliance with state and federal regulations. * Responsible for...time with or without notice. As an employer accepting Medicare and Medicaid funds, employees must comply with all… more
- CenterWell (Tallahassee, FL)
- …hands-on healthcare experience in a clinical setting, preferably within the Medicare population + Proficient with Microsoft Office applications including Microsoft ... of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Humana (Belle Glade, FL)
- …on patient plan of care. Report's problems/potential problems to RN/Case Manager .forward and of moderate complexity. The Licensed Practical Nurse participates in ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- …payor verification * Verify insurance and Medicaid coverage * Handle Dual Coverage, Medicare Part D, and Commercial Plans related to Long-Term Care * Address ... summaries * Assist residents with account balances * Ensure compliance with HIPAA and other regulations * Adhere to...* Perform additional duties as assigned by the Billing Manager Qualifications QUALIFICATIONS * High school diploma or equivalent… more
- CenterWell (Orlando, FL)
- …license. + Must have strong knowledge of governmental regulations, Medicare eligibility requirements, comprehensive understanding of potential care plan needs ... of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Actalent (Sunrise, FL)
- …utilization. Working under the general supervision of the Director and/or Manager /Supervisor of Medical Management, and in collaboration with an interdisciplinary ... Director/Physicians for requests outside standard Review Criteria. + Maintain compliance with federal, state guidelines, and contractual requirements. + Obtain… more
- CenterWell (Tallahassee, FL)
- …+ Previous experience with pharmacy benefits management + Previous Commercial, Medicare and/or Medicaid experience + Previous clinical experience in managed care ... of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- CenterWell (Tamarac, FL)
- …as a Referral Coordinator, in a clinical setting, preferably within the Medicare population** + **MUST be Bilingual English/Spanish** + Proficient with Microsoft ... of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Humana (Tallahassee, FL)
- …largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the physical, ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Molina Healthcare (Tampa, FL)
- …appropriate and correct clinical decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) ... MCG, InterQual or other medically appropriate clinical guidelines, Medicaid, Medicare , CHIP and Marketplace, applicable State regulatory requirements, including the… more