- 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 ... have comprehensive knowledge of processes, policies and procedures as well as compliance guidelines. Will support achieving operational and compliance key… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Staff Utilization Management Pharmacist (VSP/PT) is a clinical expert responsible for ... an impact** **Required Qualifications:** + **Bachelor's degree or Doctor of Pharmacy (Pharm. D .) from an accredited college of pharmacy** + Active pharmacist license… more
- Bristol Myers Squibb (Tampa, FL)
- …leadership of a team responsible for accurate and timely Managed Care Commercial and Medicare Part D rebate processing and payments, data stewardship and ... BP true-up, BP modeling of contingent/portfolio agreements, legal requests, SOX compliance , deal analytics, contract performance analytics and ad hoc data analytics… more
- Bristol Myers Squibb (Tampa, FL)
- …leadership of a team responsible for accurate and timely Managed Care Commercial and Medicare Part D rebate processing and payments, data stewardship and ... BP true-up, BP modeling of contingent/portfolio agreements, legal requests, SOX compliance , deal analytics, contract performance analytics and ad hoc data analytics… more
- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- …and payor verification * Verify insurance and Medicaid coverage * Handle Dual Coverage, Medicare Part D , and Commercial Plans related to Long-Term Care ... summaries * Assist residents with account balances * Ensure compliance with HIPAA and other regulations * Adhere to...Vision and Life insurance * 401(k) (available to both Part -Time & Full-Time employees) * Short-term and Long-term Disability… more
- Elevance Health (FL)
- …PowerPoint preferred. + Project management certification preferred. + Marketing experience preferred. + Medicare Part D experience preferred. + Fraud waste ... + Manages and coordinates the development, approval, implementation and compliance of on-going external client facing programs. + Develops...and expectations for time onsite will be discussed as part of the hiring process. The health of our… more
- Aveanna Healthcare (Daytona Beach, 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 ... to a patient. * Demonstrated proficiency in clinical assessments, documentation and compliance with aide care and policies and procedures Additional state specific… more
- 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 ... Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable...Dental, and Vision insurance + 401 (k) (available for Part Time & Full Time EEs) + Company Paid… more
- 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 ... + Exposure to Databricks, Spark, or similar data platforms + Familiarity with Medicare Advantage or Medicaid programs + Awareness of CMS audit processes or… more