• Medical Director -Pharmacy Appeals

    Humana (Tallahassee, FL)
    …in a medical management review organization such as Medicare Advantage, managed Medicaid , or Commercial health insurance + Experience with national guidelines, such ... leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
    Humana (08/22/25)
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  • AVP, Encounters

    Molina Healthcare (Jacksonville, FL)
    …evaluate, and submit encounter deletions for Medicare Advantage, ACA, and Medicaid lines of business. This role has decision-making accountability for ensuring ... or above. + Extensive understanding of Medicare Advantage, ACA and Medicaid risk adjustment processes, including encounter data submission and deletion requirements… more
    Molina Healthcare (08/22/25)
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  • Citizen Services Operations Manager

    MyFlorida (Tallahassee, FL)
    …of Florida, including in areas of criminal appeals, civil litigation, consumer protection, Medicaid fraud, and victims and civil rights. We invite you to visit our ... exposure to a broad range of topics including consumer issues, Lemon Law, Medicaid Fraud, identify theft, and more. This experience is valuable for promotion into… more
    MyFlorida (08/22/25)
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  • RN Care Manager - Remote, nationwide

    Humana (Tallahassee, FL)
    …flexibility in care manager's schedule. **Duties:** + Telephonically assess Medicare, Medicaid , and/or and Group Account members and create actionable and measurable ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. ​ **Equal… more
    Humana (08/22/25)
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  • AVP, Duals Market Enablement (Remote)

    Molina Healthcare (Tampa, FL)
    …or equivalent combination of relevant education and experience + Medicare and/or Medicaid Managed Care experience + Quantitative aptitude + Strong leadership in a ... experts, and external resources. **PREFERRED QUALIFICATIONS:** + Integrated products ( Medicaid -Medicare) experience + Experience in regulatory regulations and monitoring… more
    Molina Healthcare (08/22/25)
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  • Registered Behavior Technician RBT - Sign on Bonus…

    Butterfly Effects (Orlovista, FL)
    …Behavior Technician $500 Sign on Bonus with active RBT Certification & Medicaid MULTIPLE POSITIONS AVAILABLE!! Butterfly Effects' Mission is to make a socially ... Minimum of High School diploma. College course work a plus + RBT Certification & Medicaid Provider number + A love and Passion for working with children + Interest… more
    Butterfly Effects (08/22/25)
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  • Primary Care Physician

    CenterWell (Deerfield Beach, FL)
    …preferred . Active and unrestricted DEA license . Medicare Provider Number . Medicaid Provider Number . Minimum of two to five years directly applicable experience ... leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
    CenterWell (08/22/25)
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  • RN Clinical Supervisor - Hybrid Schedule

    Aveanna Healthcare (West Palm Beach, FL)
    …children, adolescents, and adults. Note: As an employer receiving Medicare and Medicaid funds, Aveanna employees must comply with all health-related requirements in ... Aveanna's supportive and dynamic environment! As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all… more
    Aveanna Healthcare (08/21/25)
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  • Utilization Management Nurse

    Actalent (Sunrise, FL)
    …+ Utilization review + Utilization management + InterQual + Milliman Commercial Guidelines + Medicaid + Medical management + Medicare + Managed care + Patient care + ... review concepts, including InterQual and Milliman Criteria. + Knowledge of Florida Medicaid Program and CMS Guidelines. + Proficient in word processing software,… more
    Actalent (08/21/25)
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  • Finance Specialist (Social Security and Master…

    Communities Connected for Kids (Port Saint Lucie, FL)
    …and procedures + Conducts Pre-Service training with new hired staff, explaining the Medicaid program, Master Trust policies and procedures and the proper channels of ... organization, accounting, and/or finance. Preferred: Prior experience with child welfare, Medicaid , the Social Security Administration, and/or FSFN. Apply for this… more
    Communities Connected for Kids (08/21/25)
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