• Primary Care Physician

    CenterWell (Apopka, FL)
    **Become a part of our caring community and help us put health first** Humana's Primary Care Organization is one of the largest and fastest growing value-based care, ... Our care team consists of doctors, advanced practice professionals, pharm D , care coach nurses, medical assistants, behavioral health, specialists, quality-based… more
    CenterWell (07/24/25)
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  • Encounter Data Management Professional

    Humana (Tallahassee, FL)
    **Become a part of our caring community and help us put health first** Become a part of our caring community and help us put health first The Encounter Data ... PowerPoint) + Working knowledge of SQL + Familiarity with EDI X12 formats (837P/I/ D , 999, 277, 835, 270/271, 834) + Demonstrated ability to identify process gaps… more
    Humana (08/16/25)
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  • Formulary Strategy Pharmacist Lead

    Humana (Tallahassee, FL)
    …or other pharmacy related field + Experience in Formulary strategy/development and CMS Part D guidance + Experience in analysis and problem-solving + Excellent ... **Become a part of our caring community and help us...methods to develop and influence formulary strategies for Humana's Medicare line of business. + Utilizes broad understanding of… more
    Humana (08/15/25)
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  • Field Care Manager, Ltss (RN)

    Molina Healthcare (FL)
    …Opportunity for a Texas licensed RN to join Molina to work with our Medicare members in the San Antonio service delivery area; candidates should reside in Bexar ... County. Part of the responsibilities of the role is to...to those candidates with previous experience working with the Medicare population within a Managed Care Organization (MCO). Mileage… more
    Molina Healthcare (07/20/25)
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  • Home Health Aide for Medically Fragile Children

    Aveanna Healthcare (Lakeland, FL)
    …Nurse Aide training and competency evaluation program pursuant to the requirements of 42 CFR part 483, Subpart D ; or o Health Care or Personal Care credentialing ... change at any time with or without notice. As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all… more
    Aveanna Healthcare (08/23/25)
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  • Prior Authorization Technician - Remote

    Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
    …+ Research, analyze and appropriately resolve rejected claims by working with national Medicare D plans, third party insurance companies, and all state Medicaid ... full time employees + Medical, Dental, and Vision insurance + 401 (k) (available for Part Time & Full Time EEs) + Company Paid Life insurance + Short-term and… more
    Polaris Pharmacy Services, LLC (08/22/25)
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  • Risk Adjustment Audit Operations Analyst - RADV

    Molina Healthcare (St. Petersburg, FL)
    …and team learning. + Participate in internal simulations and mock audits as part of proactive audit readiness. + Contribute to the investigation of data ... Databricks, Spark, or similar data platforms + Familiarity with Medicare Advantage or Medicaid programs + Awareness of CMS...package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/ D /V. Pay Range: $77,969 - $128,519 / ANNUAL *Actual… more
    Molina Healthcare (08/08/25)
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  • Pharmaceutical Trade Relations Sr Dir - Remote

    Prime Therapeutics (Tallahassee, FL)
    …PBM industry, Medicaid, Medicare , and health plans + Pharmacist / Pharm D + Experience with contract language and risk mitigation concepts Every employee must ... are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at ### or email… more
    Prime Therapeutics (08/08/25)
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