- Humana (Tallahassee, FL)
- … Guidance on following and reviewing home health, SNF, DME, dual Medicare / Medicaid and Waiver requests. The Medical Director provides medical interpretation ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Humana (Tallahassee, FL)
- …hours** **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other ... Utilization management experience in a medical management review organization, such as Medicare Advantage, Managed Medicaid , or Commercial health insurance. +… more
- Convey Health Solutions (Fort Lauderdale, FL)
- …Compliance: Ensure all products, processes, and activities comply with CMS (Centers for Medicare & Medicaid Services) regulations, as well as other federal and ... seeks a highly skilled and results-driven Senior Product Manager to lead our Medicare Advantage Risk Adjustment solution portfolio. In this critical role, you will… more
- Humana (Tallahassee, FL)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... Responsible for end to end market support for assigned Medicaid markets to ensure markets achieve their VBP contract...changes to existing VBP models + Coordinate internally with Medicaid VBP model design, contracting, and operations and analytics… more
- Guidehouse (Tampa, FL)
- …various types of authoritative information. + Maintains current knowledge of Medicare , Medicaid , and other third-party payer billing compliance guidelines ... on provider/clinical documentation. + Knowledge, understanding and proper application of Medicare , Medicaid , and third-party payer UB-04 billing and reporting… more
- Humana (Tallahassee, FL)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... of everything it does. Are you passionate about the Medicare population, looking for a role in management with...self-driven individuals to join our team. Our Senior Manager, Medicare Sales, motivates and drives a team of … more
- MyFlorida (Tallahassee, FL)
- …is responsible for analyzing, developing, implementing, coordinating, and/or monitoring contracted Medicare and Medicaid services within the Bureau of Plan ... travel with us without accommodation MINIMUM QUALIFICATIONS REQUIREMENTS One (1) years of Medicaid or Medicare Contract Management experience. One (1) year of… more
- Humana (Tallahassee, FL)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... our caring community and help us put health first** This role supports Medicaid state reporting initiatives for its managed care operations across multiple states.… more
- Merck (Tallahassee, FL)
- …on how the products are covered under the benefit design (Commercial, Medicare , Medicaid ) * Answer questions about coverage, including payer-specific access ... matter expert on access and affordability challenges across various payer types, including Medicare , Medicaid , and commercial plans * Educate and update HCPs on… more
- CVS Health (Tallahassee, FL)
- …able to manage multiple health plan clients across multiple lines of business including Medicare , Medicaid , Exchange, and Commercial. This is a remote role, open ... + Demonstrated understanding of CVSH clinical portfolio, marketplace segments dynamics ( Medicare , Medicaid , Exchange, and or Commercial) and industry trends… more