- AdventHealth (Altamonte Springs, FL)
- …allied health practitioners, nursing, and care management. This includes quarterly compliance updates from Medicare . + Effectively and appropriately communicates ... will contribute:** Under general supervision of the Clinical Documentation Integrity (CDI) Manager , and in some situations the supervision of the Director of… more
- CenterWell (Port Orange, FL)
- …local primary care "on-call" program of Conviva as needed. . Assures personal compliance with licensing, certification, and accrediting bodies. . Spend 100% of your ... two to five years directly applicable experience preferred . Experience managing Medicare Advantage panel of patients with understanding of Best Practice in… more
- CenterWell (Daytona Beach, FL)
- …local primary care "on-call" program of Conviva as needed. . Assures personal compliance with licensing, certification, and accrediting bodies. . Spend 100% of your ... two to five years directly applicable experience preferred . Experience managing Medicare Advantage panel of patients with understanding of Best Practice in… more
- Surgery Care Affiliates (Tallahassee, FL)
- …class. + When the patient's insurance is Out of Network notify the manager immediately. Follow the Policies and Procedures when accepting Out of Network payers. ... + The Insurance Verifier will call each patient as part of center compliance with CMS Conditions for Coverage guidelines in contacting patient's prior to the… more
- ChenMed (Miami, FL)
- …requirements and point of contact with each payor. + Supports Credentialing Manager with new market projects + Fields and resolve credentialing related questions ... Identifies process improvement opportunities and presents recommendations to Credentialing Manager and other leadership stakeholders. + Identifies issues that… more
- Aveanna Healthcare (Jacksonville, FL)
- …- $70,000.00 per year Position Details Position: Clinical Supervisor (RN) Clinical Case Manager Join a Company That Puts People First! Aveanna Healthcare is one of ... + Collaborate with the operations and business development team. + Ensure compliance with State, Federal, Local, and Aveanna policies and procedures. Qualifications… more
- CenterWell (Tallahassee, FL)
- …Experience working in coding languages such as SAS and SQL + Prior Medicare Advantage or health insurance background + Additional skills developing reports and ... role provides a unique opportunity to get hands on Medicare Advantage experience in a rapidly growing area outside...of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing… more
- CenterWell (Tallahassee, FL)
- …innovation for chronically and temporarily homebound, polychronic, and high-risk Medicare patients within a full-risk, value-based framework. The Medical Director ... with clinicians, executives, and operational leaders. + Advanced knowledge of Medicare regulations, value-based care principles, and best practices for complex care… 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 ... care environment in a value-based relationship environment. + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators **Additional… 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