- AdventHealth (Daytona Beach, FL)
- …responsible for, but not limited to: Coordination of Care, Centers for Medicare & Medicaid Services (CMS) Conditions of Participation, Social Services implementation ... of processes based upon data management, accountability for Length of Stay, Excess Days, Avoidable Days, Readmission Prevention, and Discharge Planning. In addition, the Care Management Manager is responsible for department engagement, customer experience,… more
- Sumitomo Pharma (Tallahassee, FL)
- …knowledge and understanding of the payer landscape including commercial, Medicaid, and Medicare or relevant experience. + Demonstrates the ability to analyze complex ... data to develop strategic and actionable business plans to deliver sales results. + Candidates must have excellent communication & organizational skills and be proficient with technology platforms and business hardware/software. **Education and Experience** +… more
- MyFlorida (Clearwater, FL)
- …state licensure and federal certification requirements for participation under Medicare /Medicaid. The incumbent will document findings and complete written reports ... of survey findings. The incumbent may be required to perform surveys as an individual, team member or team leader. As assigned by management, this position is required to successfully complete the Surveyor Minimum Qualifications Test within the first 12 months… more
- University of Miami (Hialeah, FL)
- …the mandates by state and federal programs, inclusive of the Centers for Medicare and Medicaid Services. Maintains fluency of provider workflows across UHealth that ... influence outcome measures. Participates in strategic planning and conduct problem analysis for senior management. + Performs measurement and benchmarking of performance measures in relation to best practices for the healthcare service industry and internal… more
- MyFlorida (Largo, FL)
- …receivables functions to maintain the billing. + Process monthly billing for all Medicare A&B, Medicaid, Medicaid Managed Care, Third Party Insurers, and any other ... payer for the State Veterans' Homes. + Review and monitor resident accounts ensuring that the account set up and payer types have been correctly established by the facility. + Verify insurance eligibility. + Review and monitor accounts on a daily basis to… more
- Aveanna Healthcare (North Port, FL)
- …Health Therapy and completion of OASIS documentation As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements ... in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate. Notice for Job Applicants Residing in California (https://www.aveanna.com/CaliforniaPrivacyNotices.html) Apply more
- Oracle (Tallahassee, FL)
- …visualization tool like BO or Tableau + Healthcare experience with Medicaid/ Medicare Claims Reporting **Expectations** + Perform other responsibilities as assigned + ... Willing to work additional or irregular hours as needed and allowed by local regulations + Work in accordance with corporate and organizational security policies and procedures, understand personal role in safeguarding corporate and client assets, and take… more
- Molina Healthcare (Miami, FL)
- …on fraud investigations. + Knowledge of Managed Care and the Medicaid and Medicare programs as well as Marketplace. + Understanding of claim billing codes, medical ... terminology, anatomy, and health care delivery systems. + Understanding of datamining and use of data analytics to detect fraud, waste, and abuse. + Proven ability to research and interpret regulatory requirements. + Effective interpersonal skills and customer… more
- Humana (Tallahassee, FL)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. ... **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic… more
- Molina Healthcare (Jacksonville, FL)
- …compliance with National Committee for Quality Assurance (NCQA) and Centers for Medicare and Medicaid Services (CMS). * Assists with the recruitment and orientation ... of new psychiatric medical directors. * Ensures all behavioral health programs and policies are in line with industry standards and best practices. * Assists with new program implementation and supports for health plan in-source behavioral health services.… more