- University of Miami (Miami, FL)
- …related to pathology, laboratory, and state/ federal regulations. + Completes the Medicare Secondary Payer Questionnaire (MSPQ) at time of scheduling prior to ... services being rendered and in accordance with Centers for Medicare & Medicaid Services (CMS) Federal regulations, as needed. + Reviews and processes information… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- …contracting and in-depth understanding of GPO/PBM/National and Regional Health Plan business models, Medicare Part D, Medicare Part B, 340B, and the changing ... market landscape + In-depth knowledge of patient access, launch excellence, marketing and business processes + Strong government pricing knowledge and experience + Strong financial acumen, forecasting, and modeling abilities + Proven ability to navigate… more
- University of Miami (Palm Beach Gardens, FL)
- …HIPAA Notice of Privacy, No Surprise Billing, Good Faith Estimate, Off Campus Medicare Co-insurance and Advance Beneficiary Notices, and Medicare Secondary Payer ... Questionnaire. + Serves as gatekeeper, performs insurance verification, and obtains referrals and/or authorizations as needed. + Provides financial counseling services at check-in, explains benefits, creates estimates, and notifies patients of self-pay… more
- Humana (Tallahassee, FL)
- …Certified Risk Coder (CRC) + Experience interacting with healthcare providers + Medicare Risk Adjustment knowledge + Analyzing data to build unique education ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Humana (Tallahassee, FL)
- …+ SAS and/or Databricks experience + Programming experience in SQL and VBA + Medicare Part D knowledge Travel: While this is a remote position, occasional travel to ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Prime Therapeutics (Tallahassee, FL)
- …processes, and participates in committee review meetings within the Commercial, Medicare , Medicaid, and Health Insurance Marketplace for the assigned department. ... interpret regulations into operational requirements **Preferred Qualifications** + 2 years Medicare Part D, Medicaid, and/or state or federal regulatory experience +… more
- Gentiva (Orlando, FL)
- …performance improvement + Drive clinical quality and ensure services meet Medicare Conditions of Participation, state hospice regulations, and Gentiva standards + ... experience, preferably in hospice or healthcare + Experience with Medicaid/ Medicare regulations and reimbursement + Strong understanding of hospice operations… more
- Humana (Tallahassee, FL)
- …2+ years SQL experience, or equivalent skillset **Preferred Qualifications** + Medicare Advantage background + Creative, high degree of self-accountability + ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- CenterWell (Middleburg, FL)
- …two to five years directly applicable experience preferred . Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... coordinated care environment in a value-based relationship environment . Knowledge of Medicare guidelines and coverage . Knowledge of HEDIS quality indicators .… more
- Humana (Tallahassee, FL)
- …to day flexibility in care manager's schedule. **Duties:** + Telephonically assess Medicare , Medicaid, and/or and Group Account members and create actionable and ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more