• Value-Based Reimbursement Specialist

    Highmark Health (Tallahassee, FL)
    …gain share and risk share models and will be implemented for the Organization's Medicare Advantage , Medicaid, ACA, and commercial populations with the goal of ... interpretation, and outcomes strategic plan development. + 1 year experience with Medicare STARS, Medicaid HEDIS, risk revenue value streams, and population health… more
    Highmark Health (08/20/25)
    - Related Jobs
  • HR Coordinator

    WTW (Fort Myers, FL)
    …a leading direct-to-consumer insurance services business, specializing in the distribution of Medicare Advantage , Medicare Supplement and Life & Supplemental ... insurance policies. Our focus is on leveraging our highly skilled team of over 3,000 professionals to deliver innovative solutions for our insurance carrier partners and provide consumers with best-in-class experience. We work with some of America's largest… more
    WTW (08/18/25)
    - Related Jobs
  • Senior Analyst, Healthcare Analytics (Risk…

    Molina Healthcare (St. Petersburg, FL)
    …proficiency in running all applicable risk models including the various CMS models for Medicare Advantage members, the HHS model for Commercial ACA members, the ... Performs analysis across multiple states and lines of business ( Medicare , Medicaid, Marketplace ACA). **KNOWLEDGE/SKILLS/ABILITIES** + Compiling and organizing… more
    Molina Healthcare (07/17/25)
    - Related Jobs
  • CTV Media Buyer

    WTW (Miami, FL)
    …a leading direct-to-consumer insurance services business, specializing in the distribution of Medicare Advantage , Medicare Supplement and Life & Supplemental ... insurance policies. Our focus is on leveraging our highly skilled team of over 3,000 professionals to deliver innovative solutions for our insurance carrier partners and provide consumers with a best-in-class experience. We work with some of America's largest… more
    WTW (06/26/25)
    - Related Jobs
  • APP, Supervisor - General Internal Medicine - Full…

    University of Miami (Miami, FL)
    …as assigned by the Chief and/or clinic Medical Director + Experience with Medicare Advantage (65+) patient population preferred + Completion of Medicare ... annual wellness exam documentation preferred + Knowledge of HEDIS Quality Care Gaps - review and closure preferred + Knowledge of Hierarchical Condition Category (HCC) - review and recertification preferred + Physical presence required at all GIM sites +… more
    University of Miami (06/16/25)
    - Related Jobs
  • Consultant, Actuarial Services

    AdventHealth (Altamonte Springs, FL)
    …ACO REACH, and commercial ACOs, is also desired but not essential. Experience with Medicare Advantage is also relevant but isnt a significant consideration and ... isnt essential. While the position involves some analytics-style work, most deliverables expected to be in the actuarial-finance area instead of the actuarial-analytics area. Additionally, high levels of professionalism including comfort with coordination in a… more
    AdventHealth (09/06/25)
    - Related Jobs
  • Primary Care Physician

    ChenMed (Clearwater, FL)
    …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... be America's leading primary care provider, transforming care of the neediest population. Our mission is to honor seniors with affordable VIP care that delivers better health. In order to achieve our vision and deliver our mission, we need the best primary… more
    ChenMed (09/06/25)
    - Related Jobs
  • Claims Examiner II

    DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
    …MSP preferably + Medical terminology + Computer literacy + Knowledge of current Medicare Advantage operational and regulatory guidelines established by CMS, AHCA ... and other federal and state regulatory guidelines. + Excellent organizational skills + Ability to work well under pressure and difficult situations Note: This description indicates, in general terms, the type and level of work performed and responsibilities… more
    DOCTORS HEALTHCARE PLANS, INC. (09/05/25)
    - Related Jobs
  • Sr. VP of FMO

    Insight Global (Miami, FL)
    …field sales teams, agents and channel performance * Deep understanding of ACA, Medicare Advantage , and Life insurance distribution * Bilingual in English and ... Spanish Excellent communication, negotiation and leadership Any relevant License null We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal employment… more
    Insight Global (08/30/25)
    - Related Jobs
  • Field Sales Professional

    CenterWell (Tampa, FL)
    …marketing; ideally field sales with a focus on senior value-based care models or Medicare Advantage . + In-depth knowledge of senior healthcare market dynamics. + ... Exceptional communication and interpersonal skills, with the ability to engage and build rapport with diverse stakeholders, including seniors, caregivers, and licensed agents. + Strong consultative selling skills, with a demonstrated ability to understand… more
    CenterWell (08/30/25)
    - Related Jobs