- Sedgwick (Tallahassee, FL)
- …Contacts providers and attorneys to obtain clarification of documentation needed to support the preparation of Medicare Set-Aside allocations. + Creates ... Fortune Best Workplaces in Financial Services & Insurance RN Medicare Compliance Sr **PRIMARY PURPOSE OF THE ROLE:** To...culture. + Passionate about creativity. + Craves culture of support , both giving and receiving. + Thrives when everyone… more
- CVS Health (Tallahassee, FL)
- …in achieving their goals. **Required Qualifications** + 5 years of experience in Medicare sales support or administration roles + Strong proficiency in sales ... each and every day. **Position Summary** The Manager, Sales Support will oversee and enhance the efficiency of the...the Sales Center of Excellence by managing various sales support systems and processes. This role is pivotal in… more
- Molina Healthcare (Orlando, FL)
- …and within Molina State plans for intervention development and execution to support Medicare Stars measure level improvement and program revenue maximization ... existing healthcare quality improvement initiatives and education programs supporting Medicare Star Ratings improvement for Clinical HEDIS measures. Responsible for… more
- Elevance Health (Tampa, FL)
- …to transform federal health programs. The **Audit and Reimbursement Senior** will support our Medicare Administrative Contract (MAC) with the federal government ... and Human Services). The Audit and Reimbursement Senior will support contractual workload involving complex Medicare cost...Senior will support contractual workload involving complex Medicare cost reports and Medicare Part A… more
- Humana (Tallahassee, FL)
- …weekend coverage + Develop collaborative relationships with Team and key partners within the Medicare Line of Business. + Support Home Solutions as needed + ... help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health, SNF, DME, dual Medicare… more
- Humana (Tallahassee, FL)
- …other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and Medicaid requirements, and will understand how ... contracted external physicians, physician groups, facilities, or community groups to support regional market priorities, which may include an understanding of Humana… more
- BayCare Health System (Clearwater, FL)
- …home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy ... of BayCare Health Plans and be responsible for prospecting and selling BayCarePlus Medicare Advantage plans to our Medicare community. + Responsibilities include… more
- Actalent (Orlando, FL)
- Medicare Coverage Analyst (MCA)-Clinical Research Medicare Coverage Analyst (MCA) for a remote 6-month contract role with potential for extension Role ... Highlights: + Conduct Medicare Coverage Analysis for clinical trials + Interpret protocols...Collaborate with study teams to ensure accurate billing + Support audits and maintain compliance documentation Qualifications + Bachelor's… more
- Molina Healthcare (FL)
- …Leads and directs team that provides strategic, process improvements, and operational support to advance the goals and objectives of the Integrated Duals program. ... Affairs to assess and provide analyses for proposed changes to Medicare , and other government-sponsored healthcare program contracts, governing regulations and new… more
- Molina Healthcare (Miami, FL)
- …PST hours** Must be able to rotate weekends and holidays** Must have Medicare Appeals and IRE experience** Responsible for reviewing and resolving member and ... with the standards and requirements established by the Centers for Medicare and Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive research… more