- CenterWell (Loxahatchee, 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 (Tallahassee, FL)
- …expert on the End Stage Renal Disease (ESRD) population for Humana's individual Medicare Advantage plans. This includes: + Owning and improving our ESRD claims ... technical skills, especially SQL, VBA, and Databricks/Python + Individual Medicare Advantage experience + Knowledgeable on ESRD population **Additional Information**… more
- Humana (Tallahassee, FL)
- …in alignment with regulatory and accreditation standards, including CMS and Medicare Advantage requirements. The manager also prepares the organization for ... Sigma a plus. + Strong knowledge of CMS Conditions of Participation and Medicare Advantage regulations. + Minimum 5 years of healthcare quality experience, including… more
- MPAC Healthcare (Pensacola, FL)
- …* Responsible for all documentation requirements and keeping up-to-date on Medicare Benefit and commercial insurance plans. Key Requirements: We're looking for ... spirit accompanied by strong medical knowledge, understanding of documentation (CMS, Medicare , Medicaid) and nursing home/ hospital facility experience. * Have a… more
- Molina Healthcare (FL)
- …accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Manages team ... complicated claims, COB and DRG/RCC pricing). * Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines… more
- ChenMed (Margate, 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
- ChenMed (Largo, 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
- CenterWell (Boynton Beach, FL)
- …for TB. **Preferred Qualifications** + Active and unrestricted DEA license + Medicare Provider Number/ Medicaid Provider Number + Experience managing Medicare ... care environment in a value-based relationship environment. + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators. **Additional… more
- HCA Healthcare (Melbourne, FL)
- …you will need:** + Two years of experience within a licensed and certified ( Medicare ) home health agency required + Competent in Federal ( Medicare ) and Local ... 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… more
- Humana (Tallahassee, FL)
- …Experience working in coding languages such as SAS and SQL + Prior Medicare Advantage or health insurance background + Additional skills developing reports and ... role provides a unique opportunity to get hands on Medicare Advantage experience in a rapidly growing area outside...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more