- BayCare Health System (Sarasota, FL)
- …communication with referral sources and physicians. + Responsible for knowledge of Medicare and Managed Care regulations and requirements. + Timely response to ... referrals sources, providers, and leadership is essential. + Responsible for documenting face to face encounter, verifying POC and following Physicians which is a condition of payment. + Oversight of Care Coordination Assistant team. + Identifies patients… 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
- CVS Health (Tallahassee, FL)
- …years Industry experience in mental or behavioral health, payer, commercial, and Medicare + Proven ability to interact with, influence and collaborate with business ... leaders and producing managers at all levels + PMP certification + Experience with enterprise-wide and/or cross-functional large-scale initiatives with high degree of complexity **Education** + Bachelor's degree or equivalent professional work experience **Pay… 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 (Miami, FL)
- …and procedures to ensure accuracy, completeness, and compliance with Centers for Medicare and Medicaid Services (CMS) regulations and guidelines of risk adjustment ... data * Understand and oversee RAPS and EDPS data transmission and assist in identification of issues that impact data integrity and accuracy * Identify opportunities for data mining to ensure data gaps are minimized * Apply best practices to ensure accuracy of… 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
- 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
- HCA Healthcare (The Villages, FL)
- …to providing patients with quality care during their recovery at home. We are Medicare certified. Our patients are under the supervision of a physician and our team ... of professionals develop an individualized plan of care. Our professionals include registered nurses, licensed practical nurses, therapists, and social workers. We provide the care you need in the comfort of your own home to restore your independence.… more
- University of Miami (Miami, FL)
- …monitored and published by external regulatory agencies, ie, Centers for Medicare and Medicaid Services, Hospital Compare and Physician Compare. Collaborates closely ... with Credentialing, and IT to produce reports, monitor performance, and identify opportunities for improvement. Maintains knowledge of industry trends in quality and outcome measures.CORE JOB FUNCTIONS 1. Abstracts and analyze data to maximize productivity 2.… more
- WestCare Foundation (Key West, FL)
- …sources; + Ability to maintain an active and up-to-date knowledge of Medicaid/ Medicare and Social Security disability application procedures. + Ability to organize, ... interpret and communicate data in a comprehensive and effective manner. + Ability to network with internal and external departments and agencies. + Knowledge in the understanding and application of case management techniques + Knowledge in the understanding… more