- Wider Circle (Daytona Beach, FL)
- Company Overview: At Wider Circle, we connect neighbors for better health. Wider Circle's groundbreaking Connect For Life(R) program brings communities and ... phone or video conferencing. + A genuine interest in working with Medicare /DSNP/Medicaid populations and a commitment to building strong, supportive relationships. +… more
- Cardinal Health (Tallahassee, FL)
- …you and others at this level_** + Effectively applies knowledge of job and company policies and procedures to complete a variety of assignments + In-depth knowledge ... + Cell/Gene therapy and/or Oncology experience, preferred + Knowledge of Medicare , Medicaid and Commercially insured payer common practices and policies, preferred… more
- Humana (Tallahassee, FL)
- …(DVACO) is an accountable care organization that participates in the Centers for Medicare and Medicaid Services' Medicare Shared Savings Program (MSSP), plus ... other commercial and Medicare Advantage value based programs. DVACO is a joint...Board + Leads strategic planning efforts to develop a specialist network within the ACO + Develops a health… more
- ChenMed (Largo, FL)
- …terminology, CPT, HCPCS and ICD coding desired + An understanding of the company 's patient population, including the complexities of Medicare programs + ... and complete tasks in a timely manner. + An understanding of the company 's patient population, including the complexities of Medicare programs + Detail-oriented… more
- ChenMed (Jacksonville, FL)
- …coaches and provides training to Care Coordinators; ensures they are following company processes. Training can also include other roles as needed. + Implements ... Checklist. + Communicates alternative/approvals to Referral Coordinator. + Follows up with MMD/ Specialist /MND if no response after 24hours. + Calls and follows up… more
- Banner Health (FL)
- …knowledge of clinical documentation and its impact on reimbursement under Medicare Severity Adjusted System (MS-DRG),All Payer Group (APR-DRG) and Ambulatory Payment ... regarding charge related issues, processes and programming. Participates in company -wide quality teams' initiatives to improve coding and clinical documentation.… more
- CenterWell (Jacksonville, FL)
- …indicators (KPIs), such patient experience via Net Promoter Score (NPS) and Medicare clinical quality via HEDIS, meeting local and organizational goals + Personally ... primary care including health promotion & prevention, disease management, effective specialist & hospital co-management, and complex care management + Spend 20-30%… more
- CVS Health (Tallahassee, FL)
- …passionate about transforming health care. As the nation's leading health solutions company , we reach millions of Americans through our local presence, digital ... applicable) to ensure the ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are… more
- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- …Remote Position Type Full Time Job Category Pharmaceutical Description PRIOR AUTHORIZATION SPECIALIST (REMOTE) WHO WE ARE Polaris Pharmacy Services is an industry ... Authorization Technicians to join the Polaris team. OVERVIEW The Prior Authorization Specialist is responsible for managing and identifying a portfolio of rejected… more
- Banner Health (FL)
- …and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health ... Care Financing Administration (HCFA), as well as company and applicable professional standards. 4. As assigned, compiles daily and monthly reports; tabulates data… more