- CenterWell (Tampa, FL)
- …Medicine or Geriatric Medicine preferred . Active and unrestricted DEA license . Medicare Provider Number . Minimum of two to five years directly applicable ... experience preferred . Experience managing Medicare Advantage panel of patients with understanding of Best...in a value based relationship environment . Knowledge of Medicare guidelines and coverage . Knowledge of HEDIS quality… more
- Humana (Miramar, FL)
- …discrepancies between company records and those maintained by the Centers for Medicare and Medicaid Services. This role encompasses a range of moderately complex ... supervision, while effectively managing multiple priorities. + Familiarity with Centers for Medicare and Medicaid Services (CMS) regulations is preferred. + Must be… more
- 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 (Tallahassee, FL)
- …preferably in the health care or insurance industry, and specifically in Medicare Advantage products + Exceptional leadership and management skills, and the ability ... **Preferred Qualifications:** + Master's Degree + Knowledge of the Medicare Advantage market, products, regulations, and compliance standards **Additional… more
- CenterWell (Tallahassee, FL)
- …+ Responsible for day-to-day operations of centralized RCM offerings and Medicare Advantage financial recoveries through health plan contestations process. + Oversee ... + Thourough comprehension of third-party contracting terms with respect to Medicare (Traditional and Medicare Advantage), Medicaid, HMOs, PPOs, and… more
- CenterWell (Fort Lauderdale, FL)
- …Medicine or Geriatric Medicine preferred . Active and unrestricted DEA license . Medicare Provider Number . Medicaid Provider Number . Minimum of two to five ... years directly applicable experience preferred . Experience managing Medicare Advantage panel of patients with understanding of Best...in a value based relationship environment . Knowledge of Medicare guidelines and coverage . Bilingual is a plus… more
- CVS Health (Tallahassee, FL)
- …applicable) to ensure the ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are ... International Classification of Disease (ICD) codes required. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical… more
- Molina Healthcare (Orlando, FL)
- …medical director, and quality improvement staff. + Facilitates conformance to Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews quality referred ... restrictions to practice and free of sanctions from Medicaid or Medicare . **PREFERRED EDUCATION:** + Master's in Business Administration, Public Health, Healthcare… more
- Molina Healthcare (Tampa, FL)
- …Ownership** + Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay ... Organization (MCO) or health plan setting, including experience in Medicaid and/or Medicare , or equivalent combination of relevant education and experience + Proven… more
- ChenMed (Jacksonville, FL)
- …understanding of the company's patient population, including the complexities of Medicare programs + Exceptional organizational skills with the ability to ... + An understanding of the company's patient population, including the complexities of Medicare programs + Detail-oriented with the ability to multi-task. + Able to… more