- Humana (Tallahassee, FL)
- …Medicaid Services' Medicare Shared Savings Program (MSSP), plus other commercial and Medicare Advantage value based programs. DVACO is a joint venture among ... areas including HR. DVACO's MSSP participation accounts for the region's largest Medicare ACO grouping, with more than 2,000 physicians and approximately 70,000 … more
- Humana (Tallahassee, FL)
- …Health Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to ... + Document all calls and requests. + Search for Medicare and Medicaid Guidelines. + Process all incoming fax/emails...help people with Medicare , or both Medicare and Medicaid, achieve… more
- Medical Mutual of Ohio (Fort Myers, FL)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. **Provides ... insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and individual plans. Our plans provide peace… more
- Humana (Tallahassee, FL)
- …**Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial products, or other ... Utilization management experience in a medical management review organization, such as Medicare Advantage , managed Medicaid, or Commercial health insurance. +… more
- CVS Health (Tallahassee, FL)
- …Home** **(Aetna Medicare Pharmacy Technician)** **BUSINESS JUSTIFICATION:** Aetna Medicare Advantage members' adherence to select maintenance medications ... informs health plans' Medicare Stars quality rating and may lead to better...include but are not limited to: * Outreach to Medicare members regarding their medication adherence and offering assistance… more
- Humana (Miami, FL)
- …Health Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to ... help people with Medicare , or both Medicare and Medicaid, achieve their best possible health and wellness through plans with benefits and services they care… 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 ... Information** + This role provides a unique opportunity to get hands on Medicare Advantage experience in a rapidly growing area outside of bid season + The… more
- Humana (Tavares, FL)
- …preferably in the health care or insurance industry, and specifically in Medicare Advantage products + Proven experience in community outreach, grassroots ... role. **Preferred Qualifications:** + Master's Degree + Knowledge of the Medicare Advantage market, products, regulations, and compliance standards **Additional… more
- AdventHealth (Maitland, FL)
- …appeal processes. + Facilitate resolution to contract violations by leveraging knowledge of Medicare Advantage plans regulatory requirements and Medicare ... Senior Compliance Analyst will have expertise in Commercial and Governmental ( Medicare , Medicaid, Tricare) payer reimbursement language and methodologies. The Senior… more
- Humana (Tallahassee, FL)
- … and Medicaid Services (CMS). The CMS Stars quality rating system evaluates Medicare Advantage and Prescription Drug Plans using approximately 40 measures ... success working through ambiguity **Preferred Qualifications** + Master's Degree + Medicare Stars experience **Additional Information** As part of our hiring process… more