- Prime Therapeutics (Tallahassee, FL)
- …all provider and member materials and communications, and product ownership for Medicare and Medicaid formularies + Provide consultation and recommendations to the ... beneficial or of interest to the plan + Provide clinical guidance and support for client's Health Insurance Marketplace business + Manage incoming requests for… more
- Actalent (Miami, FL)
- …determination. Responsibilities + Process and manage denied prior authorization requests for Medicare and Medicaid patients. + Make 30-60 outbound calls per shift to ... Medicare members, primarily elderly individuals, regarding denied medication requests....+ Review submitted documentation and gather additional information to support the appeals process. + Forward completed cases to… more
- Aveanna Healthcare (Palm Beach Gardens, FL)
- …Assistance Program (EAP) - unlimited mental health telephonic counseling sessions, support with identity left, Will preparation and travel assistance + Robust ... application * Valid CPR and Drivers License Preferred: * Medicare Skilled Nursing experience * Basic understanding of Oasis...in a health care setting As an employer accepting Medicare and Medicaid funds, employees must comply with all… more
- Aveanna Healthcare (Palm Harbor, FL)
- …working with high medical acuity clients and/or clients receiving extended non‐licensed support services. This leader is responsible to provide staff orientation and ... in a healthcare setting (home health or hospice) + Medicare Skilled Nursing experience and a basic understanding of...a basic understanding of OASIS As an employer accepting Medicare and Medicaid funds, employees must comply with all… more
- CenterWell (Callahan, FL)
- …two to five years directly applicable experience preferred . Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... coordinated care environment in a value-based relationship environment . Knowledge of Medicare guidelines and coverage . Knowledge of HEDIS quality indicators .… more
- Centene Corporation (Tallahassee, FL)
- …to be initiated + Monitor prior authorization requests + Provide clinical support to internal departments and address clinical related questions + Ensure appropriate ... programs designed to impact DUR for both Medicaid and Medicare + Develop, implement, and maintain policies and procedures...pharmacy department + Participate in the coordination of the Medicare MTM program + Assist case management team with… more
- Aveanna Healthcare (Fort Myers, FL)
- …Assistance Program (EAP) - unlimited mental health telephonic counseling sessions, support with identity left, Will preparation and travel assistance + Robust ... the state of application + Valid CPR Preferred: + Medicare Skilled Nursing experience + Basic understanding of Oasis...Home Base exp a plus As an employer accepting Medicare and Medicaid funds, employees must comply with all… more
- Aveanna Healthcare (Fort Lauderdale, FL)
- …Assistance Program (EAP) - unlimited mental health telephonic counseling sessions, support with identity left, Will preparation and travel assistance + Robust ... the state of application + Valid CPR Preferred: + Medicare Skilled Nursing experience + Basic understanding of Oasis...Home Base exp a plus As an employer accepting Medicare and Medicaid funds, employees must comply with all… more
- Aveanna Healthcare (Port Charlotte, FL)
- …Assistance Program (EAP) - unlimited mental health telephonic counseling sessions, support with identity left, Will preparation and travel assistance + Robust ... application + Valid CPR and Drivers license Preferred: + Medicare Skilled Nursing experience + Basic understanding of Oasis...in a health care setting As an employer accepting Medicare and Medicaid funds, employees must comply with all… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …case rounds, quality improvement initiatives, and utilization review processes. + Support members during transitions of care, including discharge planning and ... management information accurately and in a timely manner. + Adheres to Medicare and Medicaid regulatory guidelines as it pertains to patient admission/safe… more