- CenterWell (Tallahassee, FL)
- …Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare /Medicaid Experience a plus + Current nursing ... volunteer time off, paid parental and caregiver leave), short-term and long -term disability, life insurance and many other opportunities. Application Deadline:… more
- CenterWell (Jacksonville, FL)
- …indicators (KPIs), such patient experience via Net Promoter Score (NPS) and Medicare clinical quality via HEDIS, meeting local and organizational goals + Personally ... care environment in a value-based relationship environment. + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators **Additional… more
- CenterWell (Tallahassee, FL)
- …quality and cost improvement for high-risk senior populations in full risk Medicare arrangements. This individual will help assess the value of each opportunity ... quality and value drivers in full risk care delivery, ideally in Medicare /seniors + Demonstrated ability to work collaboratively with clinical and operational… more
- CenterWell (Jacksonville, FL)
- …two to five years directly applicable experience preferred . Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... coordinated care environment in a value-based relationship environment . Knowledge of Medicare guidelines and coverage . Bilingual (English and Spanish) is a plus .… more
- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- …Dual Coverage, Medicare Part D, and Commercial Plans related to Long -Term Care * Address customer billing inquiries professionally * Enter fees and charges ... Pharmacy Services is an industry leader in both the Long -Term Care and Post-Acute Care settings. Founded in 2015,...summaries * Assist residents with account balances * Ensure compliance with HIPAA and other regulations * Adhere to… more
- HCA Healthcare (Miami, FL)
- …hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long -term care coverage, moving assistance, pet insurance and more. + Free ... From Work Program (paid time off, paid family leave, long - and short-term disability coverage and leaves of absence)...with team members in billing, revenue integrity and/or the Medicare Service Center to resolve alerts/edits + Assign interim… more
- Humana (Miramar, FL)
- …for individual patient orders. + Coordinates all supplies recall activities and assures compliance with FDA and company policies for same if applicable. + Maintains ... purchase orders if required. + Maintains inventory as required by the manager and company inventory control. + Performs equipment maintenance and record keeping… more
- ChenMed (Tampa, FL)
- …mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to be ... consultant for sickness, by helping patients set short and long -term health goals, partners with the patient to work...with the applicable managers and medical directors to ensure compliance with guidelines along with participating in risk and… more
- Molina Healthcare (St. Petersburg, FL)
- …an integrated delivery of care across the continuum, including behavioral health and long -term care, for members with high need potential. HCS staff work to ensure ... that involve clinical HCS staff. Communicates findings to the Supervisor or Manager , HCS Department for resolution. + Maintains a minimal caseload as determined… more
- Molina Healthcare (Jacksonville, FL)
- …**Highly Qualified Candidates Will Have the Following Experience-** Digital Tag Manager Programs Salesforce Marketing Cloud Google or Adobe analytics (or similar) ... Google AdWords, Tag Manager systems, (Adobe or Google) CMS (content management system)...utilizing best practices to increase lead conversion + Ensure compliance with consumer protection laws (CAN-SPAM, TCPA, etc.) and… more