- Molina Healthcare (Orlando, FL)
- …regulations, National Committee of Quality Assurance (NCQA) guidelines, and Centers for Medicare and Medicaid Services (CMS) standards. * Provides coordination ... and processing of pharmacy prior authorization requests and/or appeals. * Explains point-of-sale claims adjudication, state, NCQA and CMS policies/guidelines, and any other necessary information to providers, members and pharmacies. * Assists with clerical… more
- Molina Healthcare (St. Petersburg, FL)
- …skills, healthcare experience, and a deep understanding of Centers for Medicare and Medicaid Services (CMS) programs and regulations. ... **KNOWLEDGE/SKILLS/ABILITIES** + Articulate requirements into concise and clear directions for project members (Business Owners, Developers, Testers, etc.) to understand and execute + Facilitate collaboration across departments to ensure alignment and… more
- Baylor Scott & White Health (Tallahassee, FL)
- …and reporting to stakeholders across all lines of business (Commercial, DTE, Medicare , and Medicaid ). Candidate will oversee extracting and analyzing medical ... and pharmacy claims data, translating output into business recommendations. This individual will design, develop, and support the creation of core analytics products, standardized across the organization. The Medical Trend Analytics Manager 1 will orchestrate… more
- Aveanna Healthcare (Leesburg, FL)
- …Home Health Therapy and completion of OASIS documentation As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related ... requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate. Notice for Job Applicants Residing in California… more
- Aveanna Healthcare (Fort Lauderdale, FL)
- …hospice Sales experience (plus for Home Health experience) As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related ... requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate. Notice for Job Applicants Residing in California… more
- Aveanna Healthcare (Palm Bay, FL)
- …Home Health Therapy and completion of OASIS documentation As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related ... requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate. Notice for Job Applicants Residing in California… more
- University of Miami (Hialeah, FL)
- …the mandates by state and federal programs, inclusive of the Centers for Medicare and Medicaid Services. Maintains fluency of provider workflows across UHealth ... that influence outcome measures. Participates in strategic planning and conduct problem analysis for senior management. + Performs measurement and benchmarking of performance measures in relation to best practices for the healthcare service industry and… more
- Aveanna Healthcare (North Port, FL)
- …Home Health Therapy and completion of OASIS documentation As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related ... requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate. Notice for Job Applicants Residing in California… more
- Molina Healthcare (Jacksonville, FL)
- …quality compliance with National Committee for Quality Assurance (NCQA) and Centers for Medicare and Medicaid Services (CMS). * Assists with the recruitment and ... orientation of new psychiatric medical directors. * Ensures all behavioral health programs and policies are in line with industry standards and best practices. * Assists with new program implementation and supports for health plan in-source behavioral health… more
- Aveanna Healthcare (Reddick, FL)
- …in home health (OASIS), med surge, ER or hospice As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements ... in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate. Notice for Job Applicants Residing in California (https://www.aveanna.com/CaliforniaPrivacyNotices.html) Apply more