- Molina Healthcare (FL)
- …intervention initiatives including all lines of business (Medicare, Marketplace, Medicaid ). Executes health plan's member and community quality focused interventions ... and programs in accordance with prescribed program standards, conducts data collection, monitors intervention activity including...to identify opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may… more
- CenterWell (Miami, FL)
- …food insecurity, navigation of and application for benefits including, Medicaid , HCBS, working to reduce costs associated with prescription medications, ... + High School Diploma or equivalent + Minimum of 2 years of experience working in healthcare services and...Bachelor's Degree in applicable discipline + Familiarity with state Medicaid guidelines and application processes + Experience working with… more
- CVS Health (Tallahassee, FL)
- …position reports to the Potential Quality of Care (PQOC) nurse investigator team manager . This position is responsible for the review and evaluation of protected ... Events across all lines of business (Commercial, Medicare, and Medicaid ). Independently coordinates the clinical resolution with internal/external clinician support… more
- Elevance Health (FL)
- …Hybrid 1;** **This role requires associates to be in-office 1 - 2 days per week,** fostering collaboration and connectivity, while providing flexibility to ... performing complex actuarial studies related to risk adjustment analytics in both the Medicaid and Medicare Advantage lines of business. **How You Will Make an… more
- MyFlorida (Orlando, FL)
- …from an accredited college/university (transcripts will be required) or do you have 2 years of verifiable experience working with people with HIV at an established ... Duty . PREFERRED QUALIFICATIONS: + Eligibility Experience + Experience conducting program assessments and home visits. + Current HIV 500/501 certification. +… more
- HCA Healthcare (Tampa, FL)
- …+ Coach, facilitate, solve work problems, and participate in the work of the team 2 Job Description + Assists the Coding Manager in verifying and reporting staff ... student loan, certification support, dependent scholarships) + Colleague recognition program + Time Away From Work Program ...and/or CDI Liaisons with day-to-day operations + Assists Coding Manager in the review and improvement of processes and… more
- HCA Healthcare (Sarasota, FL)
- …assistance (tuition, student loan, certification support, dependent scholarships) + Colleague recognition program + Time Away From Work Program (paid time off, ... alert/edit, prioritizes aged accounts first, and reports to leadership 2 Job Description + Works with team members in...coding revisions to the applicable party (eg, CIS, lead, manager , international log) + Completes MOCK abstracts as necessary… more
- Humana (Tallahassee, FL)
- …with our Security Automation Product Owner, Product Security Product Manager , Product Security Governance, DevOps, Enterprise Information Protection and Enterprise ... peer organizations and other entities as necessary to benchmark Company Application Security program and keep current in best practices * Develop and mentor staff to… more
- CenterWell (Tallahassee, FL)
- …CenterWell ACO and Medicare payment model programs via the Center for Medicare and Medicaid Services (CMS), such as ACO REACH, MSSP, and future models. Under general ... teams to manage all aspects of ACO operations including program administration, contract oversight, process, performance improvement, compliance, governance,… more
- Molina Healthcare (Jacksonville, FL)
- …in healthcare claims review and/or Provider appeals and grievance processing/resolution, including 2 years in a manager role. * Experience reviewing all ... standards and requirements established by the Centers for Medicare and Medicaid . **Knowledge/Skills/Abilities** * Leads, organizes, and directs the activities of the… more