• Medical Director - Nat'l IP UM Team

    Humana (Tallahassee, FL)
    …internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to ... includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age). + Current and ongoing Board… more
    Humana (11/15/25)
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  • PCO Medical Director - UM - Part Time (Hourly)

    CenterWell (Tallahassee, FL)
    …teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to ... includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age). + Current and ongoing Board… more
    CenterWell (11/06/25)
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  • Mgr,Business Analysis (IC)

    CVS Health (Tallahassee, FL)
    …is a remote position open to candidates located anywhere in the United States** Aetna's Medicare Stars Web team is an integral part of the Medicare Stars ... team manages data environments, reporting and web applications that support Medicare and Stars-specific initiatives. **This position will include:** + Project… more
    CVS Health (10/24/25)
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  • Encounter Data Management Lead

    Humana (Tallahassee, FL)
    …ensuring the accurate and timely submission of encounter data to Medicaid, Medicare , and DSNP states, while maintaining adherence to all regulatory requirements. The ... is responsible for ensuring the integrity and accuracy of Medicaid and Medicare encounter data across multiple trading partners. This role collaborates with Product… more
    Humana (11/26/25)
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  • Health Services & Facilities Consultant

    MyFlorida (Tallahassee, FL)
    …consultative services for all matters pertaining to the state licensure and/or Medicare certification of assigned programs, and for the coordination of activities ... the work unit, other areas of the Agency, and the Centers for Medicare and Medicaid Services. The individual: *Assembles and reviews applications and supporting… more
    MyFlorida (11/25/25)
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  • Medical Office Asst GI Center

    HCA Healthcare (Gainesville, FL)
    …Scheduling** + **Confirms the patient's primary care insurance coverage is Medicare ** + **Schedules appointments within five days according to patient need ... + **Copies all insurance cards and verifies current coverage confirming that Medicare is the primary insurer.** + **Collects copies of all Advanced Directives… more
    HCA Healthcare (11/22/25)
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  • Nurse Practitioner

    CenterWell (Tampa, FL)
    …email, etc.). **Preferred:** + Experience in value-based care, primary care or Medicare Advantage settings. + Active DEA license and Medicare /Medicaid provider ... or ability to obtain DEA license and/or Medicaid and Medicare numbers + Familiarity with HEDIS quality indicators and... numbers + Familiarity with HEDIS quality indicators and Medicare guidelines. **Use your skills to make an impact**… more
    CenterWell (11/22/25)
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  • Revenue Integrity Coding Billing Specialist…

    Guidehouse (Tampa, FL)
    …revenue cycle support services through efficient review and timely resolution of assigned Medicare and third party payer accounts that are subject to pre-bill claim ... various types of authoritative information. + Maintains current knowledge of Medicare , Medicaid, and other third-party payer billing compliance guidelines and… more
    Guidehouse (11/21/25)
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  • Investigator, Coding Special Investigative Unit…

    Molina Healthcare (FL)
    …oral and written communication skills and presentation skills. + Medicare and Marketplace experience **JOB QUALIFICATIONS** **Required Education** High School ... regulations pertaining to health insurance, investigations & legal processes (Commercial insurance, Medicare , Medicare Advantage, Medicare Part D, Medicaid,… more
    Molina Healthcare (11/20/25)
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  • Market Healthcare Sales Manager

    ChenMed (Orlando, FL)
    …as Salesforce, DASH, and Availity. + Eligibility criteria in terms of Medicare , Medicaid, Low-Income Subsidies, and Special Enrollment Periods. + Organizes MGC ... and understanding of insurance representative relations + Strong knowledge of Medicare , Medicaid, Low-Income Subsidies, and Special Election Periods + Excellent… more
    ChenMed (11/20/25)
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