- HCA Healthcare (Fort Myers, FL)
- …Performs in accordance with physician's orders and under the supervision of the Clinical Manager . **What you will do in this role** : + Assesses home care patients ... + Communicates significant findings, problems and changes to Clinical Manager and physician, and documents all findings, communications, and appropriate… more
- HCA Healthcare (Sarasota, FL)
- …Performs in accordance with physician's orders and under the supervision of the Clinical Manager . **What you will do in this role:** + Assesses home care patients ... + Communicates significant findings, problems and changes to Clinical Manager and physician, and documents all findings, communications, and appropriate… more
- CenterWell (Callahan, FL)
- …two to five years directly applicable experience preferred . Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... coordinated care environment in a value-based relationship environment . Knowledge of Medicare guidelines and coverage . Knowledge of HEDIS quality indicators .… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …management information accurately and in a timely manner. + Adheres to Medicare and Medicaid regulatory guidelines as it pertains to patient admission/safe ... health diagnoses, treatments, and psychotropic medications + Knowledge of Medicaid, Medicare , and/or commercial insurance policies + Demonstrates commitment to the… more
- CenterWell (Tallahassee, FL)
- …delivery of associate-facing contact center technologies that support Pharmacy and Medicare Part D operations. This enterprise-wide platform empowers associates to ... a related field. **Preferred Qualifications:** + Understanding of pharmacy operations and Medicare Part D. + Experience with contact center platforms and CRM… more
- Aveanna Healthcare (West Palm Beach, 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 ... to infants, children, adolescents, and adults. Note: As an employer receiving Medicare and Medicaid funds, Aveanna employees must comply with all health-related… more
- Convey Health Solutions (Fort Lauderdale, FL)
- …applications and disenrollment forms for correction and submission to Centers for Medicare & Medicaid Services (CMS) + Review and complete Late Enrollment Penalty ... Monthly Reconciliation queues + Daily and Monthly Pharmacy Benefit Manager (PBM) + Monthly MMR, PWR, LIS History and...submissions All Functions + Working understanding of Centers for Medicare & Medicaid Services (CMS) guidance + Conform with… more
- BD (Becton, Dickinson and Company) (Stuart, FL)
- …of Payor Strategy and Market Access and Payer Strategy, reports to the General Manager of LMS, and is responsible for the establishment, development and execution of ... to ensure optimal coverage and maximize reimbursement from Commercial, Medicaid and Medicare plans. The individual will also have direct supervision of the contract… more
- Molina Healthcare (FL)
- …quality member intervention initiatives including all lines of business ( Medicare , Marketplace, Medicaid). Executes health plan's member and community quality ... to identify opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may...skills. **PREFERRED QUALIFICATIONS:** + 1 year of experience in Medicare and in Medicaid managed care + Experience with… 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