- Robert Half Office Team (Miramar, FL)
- …medical directors by analyzing clinical documentation in adherence to Medicare, Medicaid , and third-party payer guidelines. * Maintain and update referral ... information while tracking changes in patient status. * Verify patient eligibility and ensure insurance benefits are appropriately identified. * Coordinate callbacks… more
- Elevance Health (FL)
- …This individual works across all three lines of business (Medicare, Medicaid , and Commercial), marrying quantitative analysis with observational insights to best ... from C-suite to front-line staff strongly preferred. + Deep knowledge of Medicaid , Medicare, and commercial plans as well as value-based care models, principals,… more
- HCA Healthcare (Miramar, FL)
- …Learn more about Employee Benefits (https://careers.hcahealthcare.com/pages/employee-benefits-and-rewards) **_Note: Eligibility for benefits may vary by location._** ... + Working knowledge of Managed Care payers/contracts, Medicare and Medicaid payers/contracts, Medicare/ Medicaid Managed Care payers/contracts and medical… more
- MyFlorida (Orlando, FL)
- …but not limited to, core members of the CMAT team, the client's Medicaid Managed Medical Assistance (MMA) plan and Agency for Health Care Administration (AHCA) ... rules, policies, procedures, and processes which affect decisions and determinations of eligibility for care and management of the client's medical needs. Advocates… more
- MyFlorida (Greenacres, FL)
- …(HMS) for Employee Activity Reports (EARs); WIC FL WISE System; Florida Medicaid Management Information System (FMMIS); Florida Shots and Q-Flow. Answers phone and ... clients, community partners and the general public. Explains WIC program eligibility , application and appointment procedures including but not limited to … more
- MyFlorida (Tallahassee, FL)
- …queries to obtain and summarize data from the Agency's iConnect system, the Medicaid paid claims database (FMMIS), and other agency data systems as required for ... in the US APD participates in the US government's employment eligibility verification program (E-Verify), which electronically confirms an employee's eligibility… more
- MyFlorida (Gainesville, FL)
- …written programs and reports. Maintains compliance with state, federal and Medicaid regulations and facility protocols and procedures for implementation and ... the US APD participates in the US government's employment eligibility verification program (E-Verify). E-Verify is a program that...E-Verify is a program that electronically confirms an employee's eligibility to work in the US after completing the… more
- MyFlorida (Gainesville, FL)
- …during the assessment period. Maintains compliance with State, Federal, and Medicaid regulations. Provides training, leadership, and monitoring to ensure all Agency ... the US APD participates in the US government's employment eligibility verification program (E-verify). E-verify is a program that...E-verify is a program that electronically confirms an employee's eligibility to work in the US after completing the… more
- MyFlorida (Port St. Lucie, FL)
- …order to interview and counsel applicants to determine economic indigence for eligibility for available services. Registers and maintains client record in computer ... Reach. + Experience dealing with HMO or third-party insurance for Medicare and Medicaid and working on Department of Health's Electronic Health Record Systems. +… more
- Centene Corporation (Tallahassee, FL)
- …testing and go/no-go decisions. + Ensure integration across claims, eligibility , provider, and utilization management systems. + Oversee data/reporting integration ... 3+ years management experience required. Regulatory knowledge of Medicare, Medicaid , and/or Marketplace required; experience with multiple products preferred. Duals… more