- Humana (Tallahassee, FL)
- …submission of bids to support Humana's pricing and product development of Medicare Advantage and Prescription Drug Plans that positively impact the financial ... the bid filing + Participate in CMS audits and reviews related to Humana's Medicare bids. + Create and maintain process improvements to bid filings to continually… more
- Humana (Tallahassee, FL)
- …segment's highest priority projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Senior Strategy Advancement Professional, you ... of strategic initiatives and business areas, evolving key facets of the Medicare Advantage growth strategy, leading the development of the annual Medicare… more
- BayCare Health System (Clearwater, FL)
- …This position is responsible for government payer reimbursement related to Medicare , Medicaid and TRICARE/CHAMPUS, specifically completion of the annual Medicare ... with at least two years direct preparation of the Medicare cost report working papers and filing of the...**Candidate should have experience in several of these areas:** Medicare bad debts; DSH (Disproportionate Share); Graduate Medical Education… more
- Humana (Tallahassee, FL)
- …You'll play a key role in shaping financial insights, supporting Medicare -related initiatives, and guiding analytical projects that impact business outcomes. + ... Lead financial analytics projects, with a focus on outcomes of Medicare risk adjustment operations and initiatives. + Work independently to analyze historical and… more
- Walmart (Orlando, FL)
- …required documentation and maintaining a safe and clean work environmentComplies with Medicare and Medicaid policies and procedures by implementing and adhering to ... on policy changes and new regulations researching information to accurately process Medicare orders to ensure compliance and interpreting and documenting Medicare… more
- CVS Health (Tallahassee, FL)
- …to manage multiple health plan clients across multiple lines of business including Medicare , Medicaid, Exchange, and Commercial. This is a remote role, open to ... + Demonstrated understanding of CVSH clinical portfolio, marketplace segments dynamics ( Medicare , Medicaid, Exchange, and or Commercial) and industry trends +… more
- CenterWell (Coral Springs, FL)
- …screened for TB. **Preferred Qualifications:** Active and unrestricted DEA license Medicare Provider Number/ Medicaid Provider Number Experience managing Medicare ... coordinated care environment in a value based relationship environment. Knowledge of Medicare guidelines and coverage. Bilingual is a plus Knowledge of HEDIS quality… more
- Intermountain Health (Tallahassee, FL)
- …with ICD-10-CM and Official Coding Guidelines as determined by Centers for Medicare and Medicaid Services (CMS), National Center for Health Statistics (NCHS), US ... AND Demonstrated knowledge of government benefits and regulations related to Medicare , Medicaid or the ACA. AND Demonstrated knowledge of queries. **_Preferred… more
- Molina Healthcare (FL)
- …in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). M-F from 8am - 4:30pm EST will require ... (COB), subrogation and eligibility criteria. * Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines… more
- Molina Healthcare (Miami, FL)
- …Act** cases in accordance with the standards and requirements of Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Responsible for the ... (COB), subrogation and eligibility criteria. * Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines… more