• Referral Coordinator

    ChenMed (Largo, FL)
    …understanding of the company's patient population, including the complexities of Medicare programs + Exceptional organizational skills with the ability to ... + An understanding of the company's patient population, including the complexities of Medicare programs + Detail-oriented with the ability to multi-task. + Able to… more
    ChenMed (07/01/25)
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  • Home Health Sr Clinical Manager

    HCA Healthcare (Port St. Lucie, FL)
    …you will need:** + Two years of experience within a licensed and certified ( Medicare ) home health agency required + Competent in Federal ( Medicare ) and Local ... to providing patients with quality care during their recovery at home. We are Medicare certified. Our patients are under the supervision of a physician and our team… more
    HCA Healthcare (06/21/25)
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  • Sales Director

    WTW (Tampa, FL)
    …leading direct-to-consumer insurance services business, specializing in the distribution of Medicare Advantage, Medicare Supplement and Life & Supplemental ... leadership role within a sales center environment. + Strong understanding of Medicare and Medicaid regulations. + Demonstrated integrity and strong people leadership… more
    WTW (06/03/25)
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  • Lead Specialist, Appeals & Grievances - Remote

    Molina Healthcare (FL)
    …accordance with the standards and requirements established by the Centers for Medicare and Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Serves as team lead for a small ... benefits, subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory… more
    Molina Healthcare (08/24/25)
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  • Home Health Licensed Practical Nurse LPN Full Time

    Aveanna Healthcare (Brandon, FL)
    …active LPN License in the state of application + Valid CPR Preferred: + Medicare Skilled Nursing experience + Basic understanding of Oasis + 1-year LPN experience in ... setting + Home Care Home Base exp a plus As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all… more
    Aveanna Healthcare (08/24/25)
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  • Behavioral Health Nurse - Managed Care

    DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
    …management information accurately and in a timely manner. + Adheres to Medicare and Medicaid regulatory guidelines as it pertains to patient admission/safe ... health diagnoses, treatments, and psychotropic medications + Knowledge of Medicaid, Medicare , and/or commercial insurance policies + Demonstrates commitment to the… more
    DOCTORS HEALTHCARE PLANS, INC. (08/24/25)
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  • Pharmacy Technician/Pharm Tech/PTCB/Pharmacy Tech

    Actalent (Orlando, FL)
    …determination. Responsibilities + Process and manage denied prior authorization requests for Medicare and Medicaid patients. + Make 30-60 outbound calls per shift to ... Medicare members, primarily elderly individuals, regarding denied medication requests. + Review submitted documentation and gather additional information to support… more
    Actalent (08/24/25)
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  • Senior Analyst, Quality Management

    CVS Health (Tallahassee, FL)
    …data analysis to strategize and achieve operational targets for NCQA HEDIS and Medicare Stars * Provide analysis support for PIP reports to regulators, including ... internal and external stakeholders **Preferred Qualifications** * Medicaid and/or Medicare managed care experience **Education** * Master's degree or equivalent… more
    CVS Health (08/24/25)
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  • Home Health Registered Nurse RN PRN

    Aveanna Healthcare (Port Charlotte, FL)
    …in the state of application + Valid CPR and Drivers license Preferred: + Medicare Skilled Nursing experience + Basic understanding of Oasis + 1-year RN experience in ... a health care setting As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions,… more
    Aveanna Healthcare (08/24/25)
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  • Lead Director Network Platform Solutions

    CVS Health (Tallahassee, FL)
    …Examples include ensuring data standards are synchronized across Medicaid and Medicare platforms, ensuring duals workflows are support across systems, ensuring duals ... experience in strategy and delivery leadership roles + 5+ years of Medicare /Medicaid and/or Duals experience + Proven success navigating large scale cross functional… more
    CVS Health (08/24/25)
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