- MyFlorida (Santa Rosa Beach, FL)
- …and reports. Verifies income and information for completeness and accuracy. Verifies Medicaid eligibility using various system and other insurance portals. ... system guidelines. Verifies and updates patient/client information into Health Management System database. Obtain and verify Medicaid , Medicare and/or… more
- MyFlorida (Pensacola, FL)
- …Okaloosa, and Walton counties. The MFC RN will work in collaboration with the Medicaid Managed Care Plan, the Community Based Agency and all others in the child's ... reports, as appropriate, with MFC program stakeholders. For fee-for-service (FFS) Medicaid clients, completes MFC child/youth nursing assessments and MFC care plans.… more
- Humana (Hallandale Beach, FL)
- …first? During the period of this unpaid internship, you will work with the Medicaid Clinical Services team to ensure interaction between the company and members are ... with an opportunity to train and work with Humana's Medicaid Team for the Applied Behavioral Analysis, (ABA) contract...in this position, you will be required to confirm eligibility to participate in the DoD SkillBridge Internship and/or… more
- Evolent (Tallahassee, FL)
- …Stay for the culture. **What You'll Be Doing:** The Specialist, Provider Data Management will be a dynamic role that will encompass overall support and maintenance ... : This role works closely with our Evolent partners to support data management , claims processing, and other activities that are within scope. You will work… more
- MyFlorida (Wildwood, FL)
- …subtleties of group dynamics. This position with APD will serve staff and management across the Agency. Your work will impact the workplace culture, our community, ... and maintenance of iBudget waiver applicants; issuance and renewal of Medicaid Waiver Service Agreements (MWSA), processing provider expansion requests, and… more
- MyFlorida (Orlando, FL)
- …services to ensure there is no break in service delivery, regardless of Medicaid eligibility . KNOWLEDGE, SKILLS AND ABILITIES: Excellent verbal and written ... Redirection Liaison. Provide oversight of the day-to-day contractual operations and management of multiple contracts within the region. Ensures the department… more
- CVS Health (Tallahassee, FL)
- …compassionate. And we do it all with heart, each and every day. _Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and ... external constituents in the coordination and administration of the utilization/benefit management function. **Required Qualifications** + 3+ years of experience as… more
- CVS Health (Tallahassee, FL)
- …external constituents in the coordination and administration of the utilization/benefit management function. Required Qualifications + Registered Nurse in state of ... of Nursing experience. Preferred Qualifications + Prior authorization utilization management /review experience preferred Outpatient Clinical experience. + Knowledge of… more
- CVS Health (Tallahassee, FL)
- …next role? Join Aetna/CVS Health, a Fortune 4 company, as the Network Management Senior Manager. In this role, you will manage negotiations, conduct high-level ... initiatives and settlement activities. * Assist with the design, development, management , and or implementation of strategic network configurations and integration… more
- HCA Healthcare (Port Charlotte, FL)
- …full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility , for external clients across the country. Parallon has over ... guidelines in all interactions with the patient + In conjunction with the Medicaid Eligibility Staff visit all uninsured patients in-house + Provide estimates… more