- CVS Health (Tallahassee, FL)
- …or willingness to thoroughly learn the role of care management within Medicare and Medicaid managed care. + **Community Resources:** Familiarity with community ... the position **Preferred Qualifications** + Experience providing care management for Medicare and/or Medicaid members + Experience working with individuals with SDoH… more
- CVS Health (Tallahassee, FL)
- …CDQA) to ensure the ICD-10 codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are ... record documentation review, diagnosis coding, and/or auditing. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical… more
- Humana (Tallahassee, FL)
- …existing environment while minimizing disruption and mitigating risks + Experience with Medicare and/or Medicaid + Ability to coordinate with development and user ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Molina Healthcare (FL)
- …in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Enters denials and ... * Customer/provider experience in a managed care organization (Medicaid, Medicare , Marketplace and/or other government-sponsored program), or medical office/hospital… more
- Molina Healthcare (Tampa, FL)
- …performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **JOB QUALIFICATIONS** **Required ... - 5 years supervisory experience + Demonstrated understanding of Medicaid and Medicare programs or other healthcare plans + Experience with Databricks + Proficiency… more
- ChenMed (Jacksonville, FL)
- …Understanding of the communities served by ChenMed, including the complexities of Medicare programs to patients in the healthcare marketplace + Ability to determine ... coordinator, referral coordinator in a clinical setting, preferably within the Medicare HMO population **PAY RANGE:** $48,418 - $69,168 Salary **EMPLOYEE BENEFITS**… more
- CenterWell (Jacksonville, FL)
- …indicators (KPIs), such patient experience via Net Promoter Score (NPS) and Medicare clinical quality via HEDIS, meeting local and organizational goals + Personally ... care environment in a value-based relationship environment + Knowledge of Medicare guidelines and coverage + Knowledge of HEDIS quality indicators **Additional… more
- Aveanna Healthcare (Fort Myers, 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
- University of Miami (Miami, FL)
- …related to pathology, laboratory, and state/ federal regulations.11. Oversees the Medicare Secondary Payer Questionnaire (MSPQ) process in accordance with Centers ... for Medicare & Medicaid Services (CMS) Federal regulations.12. Reviews and processes information with discretion, maintaining confidentiality of all laboratory… more
- Humana (Tallahassee, FL)
- …and oversee execution of, numerous strategies required to ensure success for our Medicare Stars and Medicaid LOBs. The ideal candidate for this role will thrive ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more