- Molina Healthcare (FL)
- …Opportunity for a Texas licensed RN to join Molina to work with our Medicare members in the San Antonio service delivery area; candidates should reside in Bexar ... will be given to those candidates with previous experience working with the Medicare population within a Managed Care Organization (MCO). Mileage is reimbursed as… more
- CenterWell (Tallahassee, FL)
- …quality and cost improvement for high-risk senior populations in full risk Medicare arrangements. This individual will help assess the value of each opportunity ... quality and value drivers in full risk care delivery, ideally in Medicare /seniors + Demonstrated ability to work collaboratively with clinical and operational… more
- Molina Healthcare (St. Petersburg, FL)
- …Performs analysis across multiple states and lines of business ( Medicare , Medicaid, Marketplace ACA). **KNOWLEDGE/SKILLS/ABILITIES** + Compiling and organizing ... in running all applicable risk models including the various CMS models for Medicare Advantage members, the HHS model for Commercial ACA members, the CDPS model… more
- Surgery Care Affiliates (Tallahassee, FL)
- …payable, notify patient. If patient wants to proceed, obtain signature on Medicare ABN or other non-covered notification form. Financial Orientation: + Calculate ... over the counter payments/deductibles/copay/co-insurance. Knowledge of payer contracts including Medicare , Medicaid and other government contracts and guidelines and… more
- ChenMed (Miami, FL)
- …Care leadership and will make data-driven strategy recommendations in the Medicare Advantage and healthcare industry. This senior-level analyst position has the ... of four (4) years of related experience + Experience in a Medicare Advantage, Hospital Systems and/or risk-based healthcare organization, preferred We're ChenMed and… more
- Molina Healthcare (Jacksonville, FL)
- …performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **Job Qualifications** **Required ... of related experience in healthcare + Demonstrated understanding of Medicaid and Medicare programs or other healthcare plans + Analytical work experience within the… more
- CenterWell (Jacksonville, 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 . Bilingual (English and Spanish) is a plus .… more
- Kestra Medical Technologies, Inc (Sarasota, FL)
- …products regulated by the Federal Food and Drug Administration and under contract with Medicare . Kestra maintains a drug free workplace and testing is a condition of ... products regulated by the Federal Food and Drug Administration and under contract with Medicare . Kestra maintains a drug free workplace and testing is a condition of… more
- Sedgwick (Tallahassee, FL)
- …limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets. + Reports claims to the excess carrier; responds to requests ... principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business. + Excellent oral… more
- Datavant (Tallahassee, FL)
- …work environment. + Keep up to date with current coding policies for ICD-10, Medicare Advantage, HHS (ACA), and other markets. + Provide guidance and make strategic ... or inpatient setting. + Current CCS, CRC, or CPC required. + Previous Medicare Advantage Risk Adjustment, CDI, Medicaid, Commercial RA, and HEDIS experience. +… more