- AdventHealth (Altamonte Springs, FL)
- …patient notifications are provided and documented in a timely manner for compliance : Important Medicare Letters (IML), Medicare Outpatient Observation ... and world-class resource **The role you'll contribute** **:** The RN Care Manager in collaboration with the patient/family, social workers, nurses, physicians and… more
- Humana (Tallahassee, FL)
- …develop engagement best practices, and design clinical solutions for members who have Medicare and Medicaid. The Lead Product Manager partners across various ... our dual members - members that qualify for both Medicare and Medicaid. The Lead Product Manager ...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- WTW (Tampa, FL)
- …leading direct-to-consumer insurance services business, specializing in the distribution of Medicare Advantage, Medicare Supplement and Life & Supplemental ... skilled professional to join our Sales Center team as a **Sales Performance Manager .** **How the Position Works** The **Sales Performance Manager ** is… more
- Molina Healthcare (St. Petersburg, FL)
- …achieve operational goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for ... complex business challenges that impact cost containment and regulatory compliance . The position requires strong business judgment, cross-functional coordination,… more
- AssistRx (Maitland, FL)
- …privacy of patient and customer data. DUTIES AND RESPONSIBILITIES: + Assists the Compliance Manager with performing internal reviews, research and/or audits to ... additional quality checks before document finalization. + Assists the Compliance Manager in the review and management...the review and management of third-party audits. + Verifies compliance with insurer rules, Medicare , Medicaid, HIPAA,… more
- Molina Healthcare (St. Petersburg, FL)
- …as needed + Primary point of contact for the internal partners, ie Medicare Administration, Compliance and Health Plan Operations. Coordinates and facilitates ... including goal setting and score card development + Monitors and enforces compliance with enterprise-wide processes and develops workflows for all staff to follow… more
- Humana (Tallahassee, FL)
- …of the business there is limited day to day flexibility in care manager 's schedule. **Duties:** + Telephonically assess Medicare , Medicaid, and/or and Group ... community and help us put health first** The Care Manager , Telephonic Nurse 2 employs a variety of strategies,...advanced communication and interpersonal skills. This is a very compliance driven and highly visible program at Humana. The… more
- Molina Healthcare (St. Petersburg, FL)
- **Job Summary:** The Subrogation Manager is responsible for overseeing all aspects of healthcare subrogation operations across Medicaid, Medicare , and ... to support efficient and compliant subrogation operations across Medicaid, Medicare , and Marketplace populations. + Collaborate with legal, claims, provider… more
- Molina Healthcare (FL)
- **Job Description** **Job Summary** The Health Plan Operations, Payment Integrity Program Manager is an individual contributor role designed for a highly capable ... complex business challenges that impact cost containment and regulatory compliance . The position requires strong business judgment, cross-functional coordination,… more
- J&J Family of Companies (Jacksonville, FL)
- …Florida, United States of America **Job Description:** **Field Reimbursement Manager (Immunology Dermatology)- Jacksonville, FL- Johnson & Johnson HCS, Inc** ... and Customer Solutions (PECS) team is recruiting for a Field Reimbursement Manager which will be a field-based position that will include the Jacksonville,… more