- CVS Health (Tallahassee, FL)
- …all with heart, each and every day. Aetna's Revenue Integrity team is hiring Senior Coding Data Quality Auditors to support our growing risk adjustment efforts. This ... ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of...Classification of Disease (ICD) codes required. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and… more
- Humana (Tallahassee, FL)
- …surgery or hospitalization. The Home Solutions Finance team is seeking a Senior Financial Analytics Professional. This individual will work across the business, and ... performance of business and growth strategies. The position will work directly with senior management, including the Segment President, Senior Leaders and SVPs,… more
- AdventHealth (Orlando, FL)
- …record, applying appropriate ICD-10-CM/PCS coding conventions and MS-DRG Medicare Prospective Payment System requirements. Actively participates in outstanding ... responsibility for maintaining relationships that are equally respectful to all. The Senior Coder demonstrates experience and expertise, so coding quality review is… more
- Molina Healthcare (Jacksonville, FL)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst, Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... creating tools to monitor trend drivers and provide recommendations to senior leaders for affordability opportunities. Responsible for conducting complex analyses of… more
- Humana (Tallahassee, FL)
- …a part of our caring community and help us put health first** The Senior Vendor Management Professional works as liaison between vendors and organization. The ... Senior Vendor Management Professional work assignments involve moderately complex...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
- Molina Healthcare (St. Petersburg, FL)
- …Performs analysis across multiple states and lines of business ( Medicare , Medicaid, Marketplace ACA). **KNOWLEDGE/SKILLS/ABILITIES** + Compiling and organizing ... in running all applicable risk models including the various CMS models for Medicare Advantage members, the HHS model for Commercial ACA members, the CDPS model… more
- NASCO (Tallahassee, FL)
- **Overview** The Senior Corporate Counsel, Compliance & Commercial operates under general direction and is responsible for providing legal and regulatory guidance to ... laws and regulations related to our products and services, including for our Medicare Advantage and ACA Exchanges business + Interacts with vendors and customers on… more
- CenterWell (Tallahassee, FL)
- …part of our caring community and help us put health first** The Senior Specialty Consultative Pharmacist processes and dispenses Specialty Rx medication. The ... Senior Specialty Consultative Pharmacist work assignments involve moderately complex...Previous experience with pharmacy benefits management + Previous Commercial, Medicare and/or Medicaid experience + Previous clinical experience in… more
- CenterWell (Tallahassee, FL)
- …part of our caring community and help us put health first** The Senior RX Clinical Programs Pharmacist integrates programs developed to improve overall health ... outcomes with a focus on prescription drugs. The Senior RX Clinical Programs Pharmacist work assignments involve moderately complex to complex issues where the… more
- CVS Health (Tallahassee, FL)
- …records coded by internal teams prior to the submission to the Centers of Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are ... record documentation review, diagnosis coding, and/or auditing. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical… more
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