• Health Plan Operations, Payment Integrity Program…

    Molina Healthcare (FL)
    …and verbal communication skills including ability to synthesize complex information. ** PREFERRED QUALIFICATIONS:** + Experience with Medicare , Medicaid, and ... and experience. + At least 3 years of Experience with Medicaid and/or Medicare . + Proven experience owning operational projects from concept to execution, especially… more
    Molina Healthcare (08/14/25)
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  • Field Medical Director, Interventional Cardiology…

    Evolent (Tallahassee, FL)
    …Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology to help ensure the ... (5) years' experience in the practice of Cardiology is preferred + Not under current exclusion or sanction by...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
    Evolent (07/30/25)
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  • Profee Medical Coder Complex Surgical Pediatric

    Banner Health (FL)
    …EM coding (clearly reflected in your attached resume);** + **Specialty experience preferred ;** + **Must be currently certified through AAPC or Ahima, as defined ... and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health… more
    Banner Health (07/30/25)
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  • System CDI Quality Team Leader Educator

    AdventHealth (Altamonte Springs, FL)
    …nursing, and care management. This includes quarterly compliance updates from Medicare . + Effectively and appropriately communicates with physicians and other ... Department experience. . Two (2) years of Clinical Documentation Specialist experience **LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:** . Current active… more
    AdventHealth (08/07/25)
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  • Clinical Appeals Nurse (RN)

    Molina Healthcare (Tampa, FL)
    …Graduate from an Accredited School of Nursing. Bachelor's degree in Nursing preferred . **Required Experience** + 3-5 years clinical nursing experience, with 1-3 ... MCG, InterQual or other medically appropriate clinical guidelines, Medicaid, Medicare , CHIP and Marketplace, applicable State regulatory requirements, including the… more
    Molina Healthcare (08/15/25)
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  • Representative II, Accounts Receivable

    Cardinal Health (Tallahassee, FL)
    …skills and prioritizes getting the right things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will ... regulations, or third party policy. + Updates patient files for insurance information, Medicare status, and other changes as necessary or required. + Keeps email… more
    Cardinal Health (08/24/25)
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  • Cytotechnologist

    Veterans Affairs, Veterans Health Administration (Tampa, FL)
    …advice and consultation on the interpretation and application of Medicare /Medicaid standards for medical laboratory services & other cytopathology related ... Certification: Candidates must currently possess the Cytotechnologist (CT) (ASCP) or Specialist in Cytotechnology (SCT) (ASCP) certification given by the ASCP Board… more
    Veterans Affairs, Veterans Health Administration (08/14/25)
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  • Facility Coding Inpatient Complex Coder

    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 ... or an Associate's degree in a health care field. Requires Certified Coding Specialist (CCS) or Certified Outpatient Coder (COC) or Certified Professional Coder (CPC)… more
    Banner Health (07/10/25)
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  • Marketing Automation Manager (Adobe AEP/NBA)

    Humana (Tallahassee, FL)
    …the team as a Senior Product Manager working anywhere in the US. As a Specialist in NBA Execution, you'll play a hands-on role in translating strategy into real-time ... journey flows + Comfortable working in pod-based or agile cross-functional environments ** Preferred Qualifications** + Adobe certifications in AEP or AJO are a plus… more
    Humana (08/23/25)
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  • Occupational Therapist OT Home Health

    AdventHealth (Deland, FL)
    …car insurance ** Preferred qualifications:** . Recent, relevant experience in a Medicare -certified home health agency as a case-manager . Certified Case Manager . ... Certificate for OASIS Specialist - Clinical This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws,… more
    AdventHealth (08/22/25)
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