• Medicare Product Development Manager, Vendor…

    Molina Healthcare (St. Petersburg, FL)
    …with other Core Ops areas of responsibilities) within Medicare and Medicaid . Role is predicated on building relationships with vendors, stakeholders, functional ... Level Agreements between the parties. **Job Duties** + Develops Medicare and Medicaid vendor strategies aligned with CMS and State regulations, including contract… more
    Molina Healthcare (07/25/25)
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  • Compliance Analyst Principal (Performance…

    Prime Therapeutics (Tallahassee, FL)
    …Management organization, or within a highly regulated industry, including experience with Medicare, Medicaid , and the Affordable Care Act (ACA) + Must be eligible to ... in related area of study, such as Juris Doctor + Medicare Part D, Medicaid , and/or Affordable Care Act knowledge and experience **Physical Demands** + Ability to… more
    Prime Therapeutics (07/25/25)
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  • Advocate

    WestCare Foundation (Key West, FL)
    …+ Responsible for maintaining the patient's chart in compliance with State, CARF, Medicaid , and other rules and standards. + Attend and participate in training ... data in a comprehensive and effective manner. + Knowledge and understanding of Medicaid , CARF and Department of Children and Families rules and regulations. +… more
    WestCare Foundation (07/24/25)
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  • Senior Analyst, Healthcare Analytics (Risk…

    Molina Healthcare (St. Petersburg, FL)
    …analysis across multiple states and lines of business (Medicare, Medicaid , Marketplace ACA). **KNOWLEDGE/SKILLS/ABILITIES** + Compiling and organizing health care ... Advantage members, the HHS model for Commercial ACA members, the CDPS model for Medicaid members, and others as needed + Must have a strong attention to detail… more
    Molina Healthcare (07/17/25)
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  • UM Clinical Reviewer

    Centers Plan for Healthy Living (Margate, FL)
    …Living's fundamental mission is to enroll eligible individuals who are either Medicaid or Medicaid /Medicare recipients and optimize their ability to remain ... in the community rather than being institutionalized. Centers Plan for Healthy Living will accomplish this using a multi-pronged approach to care management including ongoing assessment of members' care/social needs, developing a "living care plan" that is… more
    Centers Plan for Healthy Living (07/15/25)
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  • Insurance Verification Representative (H)

    University of Miami (Miami, FL)
    …and diagnosis codes to verify and extract payment info. + Obtains Medicaid / HMO/MediPass authorizations and referrals information when necessary. + Posts Medicaid ... and other 3rd party payments in the CMS Database system as needed + Inputs Direct Services payments into the State database for Children's Medical Services (CMS) as needed. + Communicates identified problems to Supervisor / Fiscal Manager and makes… more
    University of Miami (06/30/25)
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  • RN Clinical Director

    Aveanna Healthcare (Tampa, FL)
    …adolescents, and/or adults. Note: As an employer receiving Medicare and Medicaid funds, Aveanna employees must comply with all health-related requirements, including ... 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 (06/13/25)
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  • ANM Med Surg Medical Unit 2

    AdventHealth (Davenport, FL)
    …of patient care services, including but not limited to Medicare, Managed care, Medicaid , third party providers, challenges to current health care policies, and key ... legislative initiatives at the local, state, and national level. Qualifications **The expertise and experiences you'll need to succeed:** Associates degree **or** Diploma in Nursing Specific experience as delineated by the unit of employment (see competencies)… more
    AdventHealth (09/03/25)
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  • Hospice Patient Care RN Manager

    Gentiva (Ocala, FL)
    …to apply hospice principles, industry standards, and regulatory compliance (Medicare, Medicaid , JCAHO, ACHC) + Knowledge and compassion for terminally ill patients ... and their families + Ability to lead a diverse care team while adapting to the emotional and clinical needs of patients from various backgrounds + Strong interpersonal, organizational, and leadership skills + Competency in clinical documentation and technology… more
    Gentiva (09/03/25)
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  • Reimbursement Coordinator (Patient Assistance…

    Cardinal Health (Tallahassee, FL)
    …getting overwhelmed), required * Clear knowledge of Medicare (A, B, C, D), Medicaid & Commercial payers' policies and guidelines for coverage, preferred * Knowledge ... of DME, MAC practices, preferred * Prior understanding of Medical, Supplemental, and pharmacy insurance benefit practices, preferred * Intermediate to advanced computer skills and proficiency in Microsoft Office including but not limited to Word, Outlook, and… more
    Cardinal Health (09/03/25)
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