- Humana (Tallahassee, FL)
- …appropriateness of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Represents Humana ... experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Humana (Tallahassee, FL)
- …medical necessity of services provided by other healthcare professionals in compliance with coverage policies, procedures, and performance standards. CMD represents ... experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Molina Healthcare (St. Petersburg, FL)
- …to assess, oversee, and recommend business practices to ensure adherence to and compliance with State and Federal regulatory guidelines. The Sr. Analyst develops and ... analyzes state and federal regulatory rules, contracts, and other guidance to assess compliance and support building regulatory compliance audit procedures. * At… more
- Molina Healthcare (Orlando, FL)
- …and resolve. **Knowledge/Skills/Abilities** Responsible for the oversight of regulatory compliance of Corporate Operations functions, including but not limited to ... performance of internal compliance audits, represent Corporate Operations on external regulatory or...a cadence for assessing and adjusting * Monitor internal compliance of Corporate Operations units via establishment of an… more
- Walmart (Orlando, FL)
- …on policy changes and new regulations researching information to accurately process Medicare orders to ensure compliance and interpreting and documenting ... maintaining a safe and clean work environment Complies with Medicare and Medicaid policies and procedures by implementing and...and promotes the highest standards of integrity ethics and compliance models the Walmart values to support and foster… more
- Walmart (Orlando, FL)
- …orders keeping uptodate with regulations researching information to accurately process Medicare orders to ensure compliance with appropriate regulations and ... labeling prescriptions and preparing packages and distributing medicationsComplies with Medicare and Medicaid policies and procedures by implementing and adhering… more
- AdventHealth (Maitland, FL)
- …local and industry standards, guidelines, rules and regulations to ensure compliance . + Manages department team members by providing application assistance and ... work flow knowledge and training. Shows respect and consideration for co-workers needs, concerns and beliefs. Assisting the Supervisor with managing the day to day operations. + Works reports daily, maintaining established goal(s), and notifies Director, of… more
- CVS Health (Tallahassee, FL)
- …planning to ensure consistency and interoperability across systems. + Ensure compliance with enterprise security, privacy, and regulatory standards (eg, HIPAA, ... SOC2). Required Qualifications + 7+ years of experience in software architecture, engineering, or technical leadership roles. + Proven success designing and deploying cloud-native systems across multiple platforms and teams. + Strong understanding of marketing… more
- Prime Therapeutics (Tallahassee, FL)
- …specialized needs of the targeted population; for Medicare , is Centers for Medicare & Medicaid Services (CMS) compliance compliant + Utilize Prime's MTM ... operations (eg workflow processes and case management) + Government programs ( Medicare ) knowledge **Preferred Qualifications** + Contact Center experience + Pharmacy… more
- Walmart (Orlando, FL)
- …on policy changes and new regulations; researching information to accurately process Medicare orders to ensure compliance ; and interpreting and documenting ... documentation; and maintaining a safe and clean work environment. + Complies with Medicare and Medicaid policies and procedures by implementing and adhering to rules… more