- MyFlorida (Tampa, FL)
- …by local area offices and central office. For fee-for-service (FFS) Medicaid clients, completes MFC child/youth social work assessments. Communication Provides ... of necessary MFC stakeholders including but not limited the MFC client's Medicaid Managed Medical Assistance (MMA) plan and CBC representative. Engages, advocates,… more
- CVS Health (Homestead, FL)
- …relationships by assisting with or responding to complex issues regarding Medicaid policies and procedures, plan design, contract language, service, claims or ... activities that may include, but are not limited to, database management , and contract coordination. + Performs credentialing support activities as needed.… more
- MyFlorida (Panama City, FL)
- …"Florida Medicaid Management Information System (FLMMIS) to determine client's Medicaid eligibility and ensures that Medicaid , Medicare, and third ... computer by use of the Florida Department of Health System "Health Management System" (HMS). Also responsible for registering clients, updating demographics and… more
- Humana (Miramar, FL)
- …The Pre-Service Coordinator is responsible for all aspects of referral management and accurately process incoming requests for homecare, DME/supplies and ... information from referring entity. Perform verification of benefits coverage and eligibility for services per Health Plan contract. Review referral data matching… more
- CVS Health (Orlando, FL)
- …. Handles reviews of prior claims to address potential impact on current case management and eligibility . . Creates a holistic approach to assess the need ... The Care Manager RN is responsible for driving and supporting care management and care coordination activities across the continuum of care (assessing, planning,… more
- Humana (Miami, FL)
- …connect them to the associate automatically + Employs a variety of case management strategies, approaches and techniques to manage a member's case. + Identifies ... through a screening process for potential eligibility for state and federal benefits. + Ensures member...center environment specifically but not limited to Medicare & Medicaid recipients + Previous experience with electronic case note… more
- AssistRx (Orlando, FL)
- …Leader will be responsible for overseeing the design, implementation, and day-to-day management of the company's copay assistance programs, both pharmacy and medical ... medications. + Collaborate with internal teams (eg, reimbursement, operations, account management ) and external stakeholders to tailor copay programs to specific… more
- CVS Health (Tallahassee, FL)
- …oversight of DSNP/MMP complex populations (Dual-Eligible Special Needs Plan / Medicare- Medicaid Plan) * Develop and lead clinical strategy and objectives for ... * Leverage extensive knowledge of health care delivery system, utilization management , reimbursement methods and treatment protocols for DSNP/MMP and other complex… more
- Actalent (Sunrise, FL)
- …+ Care coordination + Chronic disease management + Plan of care management + Managed care experience + Medicaid knowledge + Needs assessment Additional ... health plan, or insurance setting + Experience with Utilization Management and Care Coordination + Knowledge of Medicaid...pay range for this position is $38.00 - $38.00/hr. Eligibility requirements apply to some benefits and may depend… more
- HCA Healthcare (Orange Park, FL)
- …full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility , for external clients across the country. Parallon has over ... on income. Learn more about Employee Benefits (https://careers.hcahealthcare.com/pages/employee-benefits-and-rewards) **_Note: Eligibility for benefits may vary by location._** You contribute… more