• Care Management Support Prof

    Humana (Tallahassee, FL)
    …diversity. **Preferred Qualifications** + Special Needs Plan (SNP) in Medicare and/or Medicaid + Medical Social Work experience + Experience working with members ... 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 (08/29/25)
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  • Women's Health Clinical Account Specialist…

    Organon & Co. (Orlando, FL)
    …Assignment of Benefits (AOB) and 340B. Knowledge of Managed Care, State Medicaid , Managed Medicaid , Kaiser, Management Service Organizations, Group Purchasing ... Organizations, Independent Physician Associations, and procurement pathway in Public Segments. Also requires awareness of complexities of the Affordable Care Act (ACA), Family Planning waivers and grants, Federal and National policies, as well as religious… more
    Organon & Co. (08/29/25)
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  • Interviewing Clerk

    MyFlorida (Macclenny, FL)
    …visit using HMS systems. Verifies payment source each visit to include; Medicaid , with FMMIS System, appropriate economic evaluation or insurance. Counsel' clients ... is determined they will assist clients who are eligible for Pregnancy Medicaid (PEPW), Primary Care, Family Planning Services, Ryan White Services, The Florida… more
    MyFlorida (08/29/25)
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  • AVP, Clinical Stars & Quality Improvement (Remote)

    Molina Healthcare (Orlando, FL)
    …and performs oversight over critical Medicare Stars functions occurring in our Medicaid health plans. + Works with senior executives, Vice Presidents and others ... at least 5 years in health plan quality improvement. + 5 years Medicaid / Medicare experience. + Minimum 3 years people management experience + Demonstrated knowledge… more
    Molina Healthcare (08/28/25)
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  • Summer 2026 MBA Internship- ROMBA

    Humana (Tallahassee, FL)
    …& Clinical Innovation + Corporate Strategy & Transformation Office + Medicare & Medicaid Market Operations + Provider Relations & Network Performance + Marketing & ... 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 (08/27/25)
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  • Staff Utilization Management Pharmacist (VSP/PT)

    Humana (Tallahassee, FL)
    …residence + Eligibility to participate in federal prescription programs (eg, Medicare/ Medicaid ) + Self-directed with the ability to work effectively both ... 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 (08/27/25)
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  • Senior Human Services Program Specialist

    MyFlorida (Fort Myers, FL)
    …matter expert which includes TCA, RCA and FA expertise. + Knowledge of Family Medicaid , PEPW, Child in Care, and Relative Care Giver programs. + Assists in ... programs administered by Economic Self Sufficiency including Food and Cash Assistance, Medicaid , Partner Relations, and Refugee Programs. + Knowledge of the FLORIDA… more
    MyFlorida (08/27/25)
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  • Medical Director - Medicare Grievances and Appeals…

    Humana (Tallahassee, FL)
    …clinical experience + Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products + Must be passionate about contributing to ... 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 (08/26/25)
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  • Human Services Analyst

    MyFlorida (Fort Pierce, FL)
    …any applicable hierarchy of payer sources is used appropriately. Screens for Medicaid eligibility, PAC Waiver eligibility, Medicare A, B, and D eligibility. Verifies ... programs (PAP), benefits/health coverage programs such as SSI, SSDI, Medicaid , Medicare, housing programs, etc. Coordinating, referring, and linking clients… more
    MyFlorida (08/26/25)
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  • Audit & Reimbursement Senior

    Elevance Health (Tampa, FL)
    …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit and Reimbursement Senior** ... Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health and Human Services).… more
    Elevance Health (08/26/25)
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