• Transition of Care Associate - Licensed Practical…

    CVS Health (Tallahassee, FL)
    …advocates for members who cannot advocate for themselves. The TOC team will review prior claims to address potential impact on current case management and ... (CKD), post-acute care, hospice, palliative care, cardiac, home health with Medicare members **Preferred Qualifications** + 4+ years of Licensed Practical Nurse… more
    CVS Health (07/31/25)
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  • Senior, Compliance Risk Adjustment Analyst

    Centene Corporation (Tallahassee, FL)
    …to inquiries from state and federal regulatory agencies timely. + Quality Review all external audit deliverables for completeness and accuracy prior to submission ... landscape preferred + Risk Adjustment regulatory audit experience preferred + Medicare experience preferred Pay Range: $68,700 -123,700 annual Centene offers a… more
    Centene Corporation (07/31/25)
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  • LPN Home Health

    HCA Healthcare (Coral Springs, FL)
    …to providing patients with quality care during their recovery at home. We are Medicare certified. Our patients are under the supervision of a physician and our team ... career path, we encourage you to apply for our LPN Home Health opening. We review all applications. Qualified candidates will be contacted by a member of our team.… more
    HCA Healthcare (07/30/25)
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  • Inpatient Coder 2 (H)

    University of Miami (Medley, FL)
    …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The ... Data Set (UHDDS), and other regulatory requirements to assure proper Medicare Severity Diagnostic Related Groups (MS-DRG) assignment. + Reviews medical record… more
    University of Miami (07/30/25)
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  • Senior Risk Partner - Compliance Officer

    Highmark Health (Tallahassee, FL)
    …skills, as well as conceptual and analytic skills in order to review and articulate corporate objectives and regulations across all relevant audiences. + ... and cross-functional strategy development. + Experience with managed care, Medicare and federal and/or state regulations, quality improvement and compliance… more
    Highmark Health (07/29/25)
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  • Auditor, Risk Adjustment (Remote)

    Molina Healthcare (Miami, FL)
    …and procedures to ensure accuracy, completeness, and compliance with Centers for Medicare and Medicaid Services (CMS) regulations and guidelines of risk adjustment ... degree. **Required Experience** 3 Years in coding and medical record chart review and experience with risk adjustment data validation Required Li **Required License,… more
    Molina Healthcare (07/25/25)
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  • Quality Management Analyst 2

    University of Miami (Miami, FL)
    …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The ... monitored and published by external regulatory agencies, ie, Centers for Medicare and Medicaid Services, Hospital Compare and Physician Compare. Collaborates closely… more
    University of Miami (07/25/25)
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  • Child Case Manager

    WestCare Foundation (Key West, FL)
    …cases of individuals and ensure effective linkage to service continuum. + Ensure review of required monthly monitoring reports in order to intervene in problematic ... sources; + Ability to maintain an active and up-to-date knowledge of Medicaid/ Medicare and Social Security disability application procedures. + Ability to organize,… more
    WestCare Foundation (07/24/25)
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  • Sr Specialist, Credentialing, Network and Payor…

    Cardinal Health (Tallahassee, FL)
    …preferred + Pharmacy Technician experience a plus, not required + Familiarity with Medicare and Medicaid + Proficient in Microsoft Office (Excel VLOOKUPS) + Strong ... other status protected by federal, state or local law._ _To read and review this privacy notice click_ here… more
    Cardinal Health (07/24/25)
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  • Home Health Physical Therapist PT Full time

    Aveanna Healthcare (Gainesville, FL)
    …Documents effectively resulting in no technical or clinical denials subsequent to review of documentation by payers + Maintain effective communication between staff, ... Health Therapy and completion of OASIS documentation As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements… more
    Aveanna Healthcare (07/24/25)
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