- HCA Healthcare (Fort Walton Beach, FL)
- …with the patient, including having the Patient Choice letter signed. + Monitors Medicare patient's planned discharge dates and delivers the Important Medicare ... with PAC providers. + Demonstrates knowledge of regulatory requirements, HCA Ethics and Compliance policies. + Practices and adheres to the "Code of Conduct" and… more
- Evolent (Tallahassee, FL)
- …in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission ... by any state or federal health care program, including Medicare or Medicaid, and is not identified as an...General Service Administration (GSA), or reprimanded or sanctioned by Medicare . + No history of a major disciplinary or… more
- CenterWell (Jacksonville, FL)
- …indicators (KPIs), such patient experience via Net Promoter Score (NPS) and Medicare clinical quality via HEDIS, meeting local and organizational goals + Personally ... environment in a value-based relationship environment. + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Humana (Tallahassee, FL)
- …partnerships across internal teams and external vendors, and ensure compliance with CMS, Medicaid, and Pharmacy marketing regulations. **Key Responsibilities** ... capabilities + Ensure organizational alignment on campaign approaches and compliance with CMS, Medicaid, and Pharmacy marketing standards **Operational Excellence… more
- Humana (Tallahassee, FL)
- …value while balancing expense and business requirements, including regulatory compliance . Begins to influence department's strategy. Makes decisions on moderately ... Responsible for overseeing vendor governance for assigned vendors, ensuring compliance with organizational policies, contractual obligations, and performance standards… more
- AdventHealth (Altamonte Springs, FL)
- …for reviewing accounts for accuracy using the charge capture audit system in compliance with local, federal, and state guidelines, as well as managed care ... account charge details. Additionally, this role ensures adherence to corporate compliance plans and regulations of applicable agencies and accrediting bodies. In… more
- Veterans Affairs, Veterans Health Administration (Bay Pines, FL)
- …and timeliness of the health record and monitor and report for regulatory compliance . Position will close 10/16/25 or at 50 applicants. Whichever occurs first ... They analyze health records for accuracy, completeness, timeliness, consistency, and compliance (eg, scanned, uploaded, use of correct titles, linked to correct… more
- Humana (Tallahassee, FL)
- …through collaboration with diverse stakeholders across the enterprise, including legal, compliance , education, and IT. In this role, you will contribute to ... the enterprise, including model risk assessments, fairness evaluations, and compliance with ethical and regulatory standards. Champion transparency, accountability,… more
- Highmark Health (Tallahassee, FL)
- …with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts ... system entities in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Determine appeal action, prepare… more
- CHS (Clearwater, FL)
- …claims and customer service calls to ensure validity, accuracy, and compliance with appropriate policies, procedures, and regulations + **Health, Dental, Vision, ... customer service calls within the MPS call center. + Ensures compliance with appropriate company policies, procedures, guidelines, and reporting requirements;… more