- Molina Healthcare (FL)
- …and clinical performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **JOB QUALIFICATIONS** ... + 3 - 5 years supervisory experience + Demonstrated understanding of Medicaid and Medicare programs or other healthcare plans + Experience with Databricks… more
- Prime Therapeutics (Tallahassee, FL)
- …we make. **Job Posting Title** IT Business Systems Analyst Sr - Medicaid Pharmacy Implementations - Remote **Job Description** The IT Business Systems Analyst ... Benefit Management (PBM) or healthcare experience with understanding of Medicare, Medicaid , the Exchanges along with regulatory compliance requirements (HIPAA and/or… more
- Insight Global (Orlando, FL)
- …Diploma/GED 5+ years Backend Reimbursement experience Cost reporting experience for Medicare/ Medicaid Appeals Experience filing state surveys + external reviews such ... Diploma/GED 5+ years Backend Reimbursement experience Cost reporting experience for Medicare/ Medicaid Appeals Experience filing state surveys + external reviews such… more
- Molina Healthcare (Tampa, FL)
- …**Job Summary** Responsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment programs in multiple states. Maintain risk adjustment model, ... available to lead national risk adjustment studies. Prior experience in Medicaid risk adjustment is not required. **KNOWLEDGE/SKILLS/ABILITIES** + Analyze risk score… more
- CVS Health (Tallahassee, FL)
- …initiatives to support audit readiness and collaborates with Compliance, Legal, Medicaid Health Plans, Network Contracting, and Provider Relations to ensure ... alignment with regulatory and contractual obligations. The Lead Director will also serve as a key liaison between Compliance, Legal, Network Contracting, and Provider Relations teams. **Required Qualifications** + A minimum of 7 years of healthcare payer… more
- CVS Health (Tallahassee, FL)
- …for high volume inbound provider calls for the Claims Inquiry/Claims Research Medicaid team. Extensive claims research on multiple platforms to assist providers with ... payment questions. + Educate provider with related information to answer the unasked questions, eg, additional plan details, benefit plan details, provider self-service tools, etc. + Use customer service threshold framework to make financial decisions to… more
- Public Consulting Group (FL)
- …personnel so classified.** **Qualifications:** Required Skills/Experience * Experience with Medicaid Infrastructure Technology Architecture (MITA) * 5+ years of ... overall IT industry experience * 5+ years of experience performing project oversight and assessment for large enterprise grade information technology systems * 5+ years of experience aligning IT systems with organizational business processes. At least three… more
- WestCare Foundation (Pembroke Pines, FL)
- Medicaid Therapist Job Details Job Location Pembroke Pines - 1633 Poinciana Drive - Pembroke Pines, FL Position Type Full Time Education Level Graduate Degree Salary ... Range $50000.00 - $55000.00 Salary/year Description POSITION SUMMARY: Person in this position is responsible for the delivery of individual, and family counseling services in an office setting utilizing Telehealth sessions and completion of documentation… more
- Molina Healthcare (Jacksonville, FL)
- …We are seeking a highly skilled and forward-thinking Big Data Engineer to join our healthcare data team. This role encompasses the end-to-end design, development, and ... management of large-scale data systems tailored for healthcare analytics. The ideal candidate will be responsible for architecting and maintaining robust, scalable, and secure data pipelines that support critical decision-making across the organization. This… more
- MyFlorida (Tallahassee, FL)
- …and planning entity. The Agency is responsible for administering the Florida Medicaid program, the licensure and regulation of nearly 50,000 health care facilities, ... and high-quality health care system in the nation. The Medicaid program provides low-income families and individuals with access...the delivery of health care services through the Florida Medicaid Program. This position requires a candidate who is… more