• Home Health Clinical Manager RN

    Aveanna Healthcare (Fort Myers, FL)
    …of care and performs home visits as needed. + Ensures client compliance with federal/state regulations through policy and procedure administration to staff. + ... in a healthcare setting (home health or hospice) + Medicare Skilled Nursing experience and a basic understanding of...a basic understanding of OASIS As an employer accepting Medicare and Medicaid funds, employees must comply with all… more
    Aveanna Healthcare (12/20/25)
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  • Senior Digital Marketing Analyst

    Highmark Health (Tallahassee, FL)
    …analytics skills, and deep understanding of healthcare customer journeys-including Medicare , Medicaid, Commercial, and provider engagement pathways. Experience with ... Expertise** + Understanding ofhealthcare marketing (enrollment flows, provider networks, Medicare AEP/OEP). + Familiarity with HIPAA, PHI, consent management, and… more
    Highmark Health (12/18/25)
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  • Field Medical Director, Interventional Cardiology…

    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
    Evolent (12/18/25)
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  • DRG Clinical Dispute Reviewer

    Zelis (St. Petersburg, FL)
    …+ Perform regulatory research from multiple sources to keep abreast of compliance enhancements and additional bill review opportunities. + Support for client facing ... with providers + Experience and working knowledge of Health Insurance, Medicare guidelines and various healthcare programs + Understanding of hospital coding… more
    Zelis (12/17/25)
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  • SNF Utilization Management RN - Compact Rqd

    Humana (Tallahassee, FL)
    …states: California, Hawaii, Nevada, Oregon + Health Plan experience + Previous Medicare /Medicaid Experience a plus + Call center or triage experience + Bilingual ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
    Humana (12/12/25)
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  • Senior Stars Improvement, Clinical Professional

    Humana (Dunedin, FL)
    …responsible for the development, implementation and management oversight of the company's Medicare Stars Program in the West Coast Tampa region (Clearwater, St. ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
    Humana (12/09/25)
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  • Senior Stars Clinical Consultant RN

    Humana (Gainesville, FL)
    …responsible for the development, implementation and management oversight of the company's Medicare Stars Program in the Florida region. Ideal candidates will be ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
    Humana (12/07/25)
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  • Case Management Assistant

    HCA Healthcare (Gainesville, 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
    HCA Healthcare (12/06/25)
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  • Home Health Licensed Practical Nurse LPN PRN

    Aveanna Healthcare (Melbourne, FL)
    …at this time. Essential Job Functions + Deliver quality patient care in compliance with physician orders under direction of their Registered Nurse teammate. + ... the state of application + Valid CPR Preferred: + Medicare Skilled Nursing experience + Basic understanding of Oasis...Home Base exp a plus As an employer accepting Medicare and Medicaid funds, employees must comply with all… more
    Aveanna Healthcare (11/25/25)
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  • Associate Medical Director

    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
    CenterWell (11/21/25)
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