- 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
- Humana (Tallahassee, FL)
- …of our caring community and help us put health first** The Senior Professional collaborates with healthcare professionals, pharmacists, and other business functions ... latitude in determining objectives and approaches to assignments. The Senior Formulary Operations Management Professional collaborates with healthcare professionals,… more
- Humana (Tallahassee, FL)
- …and help us put health first** Join our innovative team as a Senior Application Architect and play a pivotal role in transforming healthcare technology! You'll ... scalable, high-impact applications, we want to hear from you. The Senior Application Architect leads technical planning, architecture development, and the creation… more
- Highmark Health (Tallahassee, FL)
- …on all efforts. + Provide proactive guidance, education, and information to senior management, so that leaders remain informed and aware of risks, requirements, ... Committee meetings of the Board. Gathers data and prepares reports for senior management and Board of Directors as needed. Ensure reporting obligations are… 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
- Humana (Tallahassee, FL)
- …a part of our caring community and help us put health first** Senior Technology Lead for Anaplan Operational Workforce Planning. They work closely with business ... and ensuring the successful delivery of high-quality Anaplan models and dashboards. Anaplan Senior Tech Lead focus on the Anaplan platform plays a crucial role in… more
- Humana (Tallahassee, FL)
- …part of our caring community and help us put health first** The Senior Inpatient Medical Coding Professional extracts clinical information from a variety of medical ... requires an in-depth evaluation of variable factors. **Responsibilities** The Senior Inpatient Medical Coding Professional confirms appropriate diagnosis related… more
- Humana (Tallahassee, FL)
- …help us put health first** We are seeking a talented and motivated Senior Cognitive/Machine Learning Engineer to join our dynamic team. The traditional candidate ... in both traditional machine learning and emerging generative AI technologies. As a Senior Cognitive/Machine Learning Engineer, you will play a key role in developing… more
- ChenMed (Miami, FL)
- …We're rapidly expanding and we need great people to join our team. The Senior Manager, Referrals is responsible for providing support to ChenMed, et. al regarding ... to guide the Chenmed company's on referral processes. The Senior Manager, Referrals is the subject matter expert in...decision based of the data + Experience working in Medicare managed care environment We're ChenMed and we're transforming… more
- Molina Healthcare (FL)
- …quality member intervention initiatives including all lines of business ( Medicare , Marketplace, Medicaid). Executes health plan's member and community quality ... excellent problem-solving skills. **PREFERRED QUALIFICATIONS:** + 1 year of experience in Medicare and in Medicaid managed care + Experience with data reporting,… more