• RN UM Clinical Appeals Nurse Remote

    Molina Healthcare (Orlando, FL)
    …highly preferred Work hours: Monday- Friday 8:00am - 5:00pm Central time Remote position **Essential Job Duties** * Performs clinical/medical reviews of previously ... Procedure Coding (HCPC). * Experience demonstrating knowledge of Centers for Medicare and Medicaid Services (CMS) guidelines, MCG, InterQual or other medically… more
    Molina Healthcare (11/14/25)
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  • LVN Delegation Oversight Nurse Remote

    Molina Healthcare (Tampa, FL)
    …compliance with the National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity requirements and all ... is highly preferred. Work hours: Monday - Friday 8:00am - 4:00pm Remote position **Essential Job Duties** + Coordinates, conducts and documents pre-delegation and… more
    Molina Healthcare (11/13/25)
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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 ... improvement, and clinical excellence. + **This position is 100% Remote and can be completed from any state. Multiple...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
    Evolent (10/29/25)
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  • Program Manager, Healthcare Services (Contract…

    Molina Healthcare (Orlando, FL)
    …(LPN), Advanced Practice Social Worker (APSW), Certified Health Education Specialist (CHES), Licensed Professional Counselor (LPC), Licensed Professional Clinical ... or other health care or management certification. * Leadership experience. * Medicaid/ Medicare population experience. To all current Molina employees: If you are… more
    Molina Healthcare (11/13/25)
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  • Senior Clinical Pharmacist - Pipeline

    Humana (Tallahassee, FL)
    …approvals, as well as modeling financial impact of emerging therapeutics across Medicare and Medicaid LOBs + Researches and analyzes drugs and emerging therapeutics, ... + PharmD + Health Plan experience + Knowledge of Medicare as it relates to pharmacy + Six Sigma...or similar pharmacy practice experience + Board Certified Pharmacotherapy Specialist (BCPS) + MBA, pharmacoeconomics or health outcomes training… more
    Humana (11/20/25)
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  • Profee Coder Surgical Urology

    Banner Health (FL)
    …ability to work your 8-hour shift between 5am-7pm (Monday-Friday). **This is a fully remote position and available if you live in the following states only: AK, AR, ... in contact with your team. Although this is a remote position we do work as a team, supporting...to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG)… more
    Banner Health (11/26/25)
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  • Oncology Sales Representative - Birmingham

    Merck (Tallahassee, FL)
    **Job Description** **Oncology Sales Representative / Specialist ** Grow and accelerate your career with our Oncology Sales organization and join a team that's driven ... Leader, Key Account Manager, Nurse Educator, Field Reimbursement Associate, Medicare Account Executive, and more. **Qualifications:** **Minimum Requirements:** +… more
    Merck (11/22/25)
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  • Facility Inpatient Complex Senior Coder

    Banner Health (FL)
    …care. Looking for a motivated, experienced **Inpatient Facility, Acute Care, Remote Medical Complex Coder** to join our talented Inpatient Facility-coding team. ... 8-hour shift between 5am-7pm (Monday-Friday). **This is a fully remote position and available if you live in the...to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG)… more
    Banner Health (10/17/25)
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  • Representative II, Accounts Receivable

    Cardinal Health (Doral, FL)
    Hybrid or Remote position Schedule: Monday - Friday, 8:00 AM - 4:30 PM EST **_What Contract and Billing contributes to Cardinal Health_** Contracts and Billing is ... skills and prioritizes getting the right things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will… more
    Cardinal Health (11/20/25)
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