• Director Reimbursement

    AdventHealth (Altamonte Springs, FL)
    …activities. These activities include preparation and filing the annual Medicare, Medicaid , and Champus/Tricare cost reports; preparation of reopening and appeal ... operational decisions; and serves as subject matter resource for Medicare and Medicaid reimbursement matters. The Director is responsible for creating a work… more
    AdventHealth (08/13/25)
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  • Lead Analyst, Payment Integrity

    Molina Healthcare (Tampa, FL)
    …Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay Edits, ... oversight. + Collaborates with operational teams, enterprise stakeholders, and finance partners to proactively identify issues and implement resolution strategies.… more
    Molina Healthcare (08/20/25)
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  • Health Plan Operations, Payment Integrity Program…

    Molina Healthcare (FL)
    …oversight. + Collaborate with operational teams, enterprise stakeholders, and finance partners to proactively identify issues and implement resolution strategies. ... requirements, workflows, and solutions that drive measurable improvement. + Partner with finance and compliance to develop business cases and support reporting that… more
    Molina Healthcare (08/14/25)
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  • Senior Encounter Data Management Professional

    Humana (Tallahassee, FL)
    …ensure successful submission and reconciliation of encounter submissions to Medicaid /Medicare. Ensures encounter submissions meet or exceed all compliance standards ... and develops tools to enhance the encounter acceptance rate by Medicaid /Medicare. Looking for long-term improvements of encounter submission processes. Begins to… more
    Humana (08/15/25)
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  • Manager Rebate Pharmacy Operations

    Prime Therapeutics (Tallahassee, FL)
    …management. Enforces teamwork across all internal departments, as well as with Medicaid Clients, and an in-depth understanding of all rebate programs, trends, and ... compliance with federal laws, state laws and standards of practice which govern the Medicaid Drug Rebate Program. + Ensures compliance with each State Medicaid more
    Prime Therapeutics (08/08/25)
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  • Lead Anaplan Architect

    Humana (Tallahassee, FL)
    …own and evolve our enterprise-wide Anaplan platform across both Workforce Planning ( Finance ) and Workforce Management (HR) domains. This role requires a rare blend ... of functional and technical expertise, deep understanding of Finance and HR business processes, and the ability to...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
    Humana (08/09/25)
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  • Revenue Cycle Manager

    Devereux Advanced Behavioral Health (Orlando, FL)
    …and tables for data analysis. + Ensure accurate billing and claims submission for Medicaid , Managed Care, and other third-party payors + Hiring and training staff. + ... commitment to Devereux. \#sponsored **Qualifications** **Education:** + Bachelor's degree in Finance , Business or related degree _required_ + 5+ yearsof experience… more
    Devereux Advanced Behavioral Health (08/27/25)
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  • Encounter Data Management Professional

    Humana (Tallahassee, FL)
    …ensure successful submission and reconciliation of encounter submissions to Medicaid /Medicare. Ensures encounter submissions meet or exceed all compliance standards ... and develops tools to enhance the encounter acceptance rate by Medicaid /Medicare. Looks for long term improvements of encounter submission processes. Understands… more
    Humana (08/22/25)
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  • Principal, Financial Planning & Analysis,…

    Humana (Tallahassee, FL)
    …business results across the CenterWell segment, both directly and through the Finance teams of each of the individual CenterWell businesses. This associate will ... to the enterprise. Key Responsibilities + Responsible for managing CenterWell level finance projects and / or deliverables that require input from multiple… more
    Humana (08/19/25)
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  • Senior Analyst, Medical Economics (Vbc) - Remote

    Molina Healthcare (FL)
    …Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key business issues related to cost, utilization and ... impact of provider reimbursement changes + Provide data driven analytics to Finance , Claims, Medical Management, Network, and other departments to enable critical… more
    Molina Healthcare (08/31/25)
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