- CVS Health (Tallahassee, FL)
- …oversight of DSNP/MMP complex populations (Dual-Eligible Special Needs Plan / Medicare -Medicaid Plan) * Develop and lead clinical strategy and objectives for ... through peer review and educational interventions. * Work with medical director teams focusing on inpatient care management, clinical coverage review, member… more
- CVS Health (Tallahassee, FL)
- …it all with heart, each and every day. **Position Summary** The Lead Director , Provider Portal Strategy & Operations is responsible for the strategic leadership and ... oversight of Aetna's three primary provider portal solutions: Availity Commercial/ Medicare Portal, Availity Medicaid Portal, and DentalXchange Dental Portal. This… more
- Aveanna Healthcare (Miami, FL)
- RN Clinical Director of Operations 10k Sign On Bonus ApplyRefer a FriendBack Job Details Requisition #: 209130 Location: Miami, FL 33166 Category: Nursing Salary: ... * Bilingual (English and Spanish) * Valid CPR As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all… more
- PruittHealth (Jacksonville, FL)
- **JOB PURPOSE:** As a Regional Admissions Director for skilled nursing and long-term care facilities, you will be responsible for overseeing all aspects of the ... in skilled nursing or long-term care settings. 3. Strong understanding of Medicare , Medicaid, and other third-party payer requirements related to admissions and… more
- Aveanna Healthcare (Brandon, FL)
- Home Health RN Executive Director ApplyRefer a FriendBack Job Details Requisition #: 209054 Location: Brandon, FL 33509 Category: Nursing Salary: $90,000.00 - ... * General Healthcare experience * Valid CPR As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in… more
- USAA (Tampa, FL)
- …makes us special and impactful. **The Opportunity** USAA is seeking a talented ** Director , Retirement Income** to lead multiple teams of Health, Life or Retirement ... with Legal, Risk and Compliance on interpretation of CMS (Center for Medicare and Medicaid Services) rules to provide guidance and clarification to executive… more
- IQVIA (Tampa, FL)
- Job Description Summary: **Associate Director Finance Operations** Directs financial planning and accounting practices including budgeting, costing, financial ... financial application software is essential. Understanding of **PBM systems and Medicaid/ Medicare billing.** + **Familiarity with NCPDP standards.** + **Knowledge of… more
- Molina Healthcare (Jacksonville, FL)
- …clinical leadership and quality improvement teams. * Facilitates conformance to Medicare , Medicaid, NCQA and other regulatory requirements. * Reviews quality ... referred issues, focused reviews and recommends corrective actions. * Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. * Attends or chairs committees as required such as credentialing, Pharmacy… more
- BrightSpring Health Services (Clearwater, FL)
- …with Company policies and procedures, state licensure and regulations, Medicaid and Medicare standards, as well as state reimbursement regulations + Leading case ... conferences and other client-related meetings + Chairing committees as appropriate, safety, infection control, incident review, and human rights committees + Facilitating communication and serving as a liaison between and among nursing and direct care staff,… more
- AdventHealth (Orlando, FL)
- …nation. We are a leading provider of cardiovascular and thoracic services among Medicare patients with national rankings that include: #1 in Cardiology volume, #1 in ... Vascular Surgery volume, #5 in Thoracic Surgery volume and #8 in Open Heart Surgery volume. The AdventHealth Heart, Lung and Vascular Institute is centered in a tertiary facility known as AdventHealth Orlando with a newly opened Ginsburg Tower. This 15-story… more