• AVP, Duals Market Enablement (Remote)

    Molina Healthcare (Tampa, FL)
    **Job Description** **Job Summary** Provides leadership to the Medicare Duals team and plays a critical role in advancing the Medicare Integrated Duals segment ... strategic priorities. Develops and executes Medicare strategies, including state-specific and product-specific growth initiatives. Leads high-priority projects… more
    Molina Healthcare (08/22/25)
    - Related Jobs
  • Encounter Data Management Professional

    Humana (Tallahassee, FL)
    …ensure successful submission and reconciliation of encounter submissions to Medicaid/ Medicare . Ensures encounter submissions meet or exceed all compliance standards ... and develops tools to enhance the encounter acceptance rate by Medicaid/ Medicare . Looks for long term improvements of encounter submission processes. Understands… more
    Humana (08/19/25)
    - Related Jobs
  • Senior Coordinator Complaint & Appeals

    CVS Health (Tallahassee, FL)
    …Tracking Module (CTM) Senior Coordinator, you will be part of the Medicare Complaints Tracking Module (CTM) Team, responsible for researching and resolving ... complaints received via the Centers for Medicaid and Medicare Services (CMS). In this role, you will manage...In this role, you will manage a queue of Medicare complaints. These complaints can include various issues ranging… more
    CVS Health (08/13/25)
    - Related Jobs
  • Non-Clinical Coding and OASIS Review Manager

    BAYADA Home Health Care (Orlando, FL)
    …Coding Review Manager provides support to all BAYADA Home Health Care Medicare service offices by monitoring Outcome and Assessment Information Set (OASIS) ... to policies and procedures. As a member of the Medicare Case Management (MCM) office, individuals in this role...the OASIS and ICD 10 coding while using the Medicare PDGM billing model and CMS guidelines. + Review… more
    BAYADA Home Health Care (08/15/25)
    - Related Jobs
  • Home Health Director

    BAYADA Home Health Care (Jacksonville, FL)
    …experienced and compassionate **Director** to manage operations at our **Jacksonville, FL Medicare -certified Home Health office** . The ideal candidate will have a ... strong background in healthcare administration, regulatory compliance ( Medicare Conditions of Participation), clinical coordination, and business operations. This… more
    BAYADA Home Health Care (08/09/25)
    - Related Jobs
  • Senior Manager, MarketPoint Sales

    Humana (Ocala, FL)
    …first** Our Senior Manager, MarketPoint Sales motivates and drives a team of Medicare Sales Field Agents who sell individual health plan products and educate ... and more. The Senior Manager, MarketPoint Sales will supervise Medicare Sales Field Agents dedicated to the growth of...will sell the portfolio of products offered to the Medicare population in The Villages. In this role you… more
    Humana (07/30/25)
    - Related Jobs
  • Delaware Valley ACO Fellowship

    Humana (Tallahassee, FL)
    …(DVACO) is an accountable care organization that participates in the Centers for Medicare and Medicaid Services' Medicare Shared Savings Program (MSSP), plus ... other commercial and Medicare Advantage value based programs. DVACO is a joint...HR. DVACO's MSSP participation accounts for the region's largest Medicare ACO grouping, with more than 2,000 physicians and… more
    Humana (07/30/25)
    - Related Jobs
  • Bilingual Telephonic UM Coordinator

    Humana (Tallahassee, FL)
    …and other vendors. + Document all calls and requests. + Search for Medicare and Medicaid Guidelines. + Process all incoming fax/emails request for services the ... recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years....over 23 years. CarePlus strives to help people with Medicare , or both Medicare and Medicaid, achieve… more
    Humana (08/16/25)
    - Related Jobs
  • Hybrid Field Sales Representative

    CVS Health (Tallahassee, FL)
    …will sell, cross-sell, up-sell, and retain through the use of the Aetna IVL Medicare product portfolio.This role will deploy an operating model that supports 3 days ... shopper initiatives, and state, federal, and CMS requirements for Medicare sales agents and programs + 0-3 Years Experience...or 1 to 2 years' experience of selling multiple Medicare products (ie, Medicare Advantage, Medicare more
    CVS Health (08/08/25)
    - Related Jobs
  • Representative II - Operations

    CVS Health (Tallahassee, FL)
    …**Position Summary** As a Rep II, Operations, you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy benefits. ... company by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines, while… more
    CVS Health (08/22/25)
    - Related Jobs